A nurse is caring for a client who has a spinal cord injury at the fourth cervical level. Which of the following mobility options should the nurse anticipate for this client?

Choice A Reason:

Obtaining a hospital bed and keeping all four siderails up, may not be the best choice. While a hospital bed with siderails may be appropriate for some individuals with Parkinson's disease who are at high risk of falls, keeping all four siderails up continuously can potentially restrict mobility and independence. It's important to balance safety with the client's comfort and ability to move independently.

Choice B Reason:

Removing all throw rugs from the home is correct. Throw rugs can be tripping hazards, especially for individuals with mobility issues or balance problems. Removing throw rugs can reduce the risk of trips and falls within the home.

Choice C Reason:

Installing handrails in the bathroom is correct. Installing handrails in the bathroom, especially near the toilet and shower, can provide additional support and stability for individuals with Parkinson's disease when performing daily activities. This can help prevent falls in a potentially slippery environment.

Choice D Reason:

Ensuring adequate lighting along walking spaces is correct. Good lighting is crucial for individuals with Parkinson's disease to see obstacles and hazards clearly. Adequate lighting along walking spaces helps improve visibility and reduces the risk of falls, especially during nighttime or low-light conditions.

Choice E Reason:

Keeping walking areas free of clutter is correct. Clutter and obstacles in walking areas increase the risk of tripping and falling, particularly for individuals with Parkinson's disease who may have difficulty with balance and coordination. Keeping walking areas clear of clutter helps create a safer environment.

Choice A Reason:

Placing the client on clear liquids might not be appropriate in this situation because absent bowel sounds in the lower abdominal quadrants could indicate a more serious gastrointestinal issue such as ileus or bowel obstruction. Clear liquids may exacerbate these conditions and are not sufficient to address the underlying problem. Therefore, this option is not recommended until the cause of absent bowel sounds is identified and addressed.

Choice B Reason:

Performing a hemoccult blood test is not directly relevant to the situation described. Hemoccult tests are used to detect occult (hidden) blood in stool, which can be indicative of gastrointestinal bleeding. While it's important to assess for gastrointestinal bleeding in some cases, absent bowel sounds in the lower abdominal quadrants suggest a more immediate concern related to gastrointestinal motility rather than bleeding. Therefore, this option is not the most appropriate action at this time.

Choice C Reason:

Inserting a nasogastric tube is the most appropriate action in this scenario. Absent bowel sounds in a client with a spinal cord injury can indicate neurogenic bowel dysfunction, which may lead to abdominal distention and discomfort. Inserting a nasogastric tube can help decompress the stomach and intestines, reducing the risk of complications such as aspiration and providing relief from discomfort. It can also help manage gastrointestinal complications until further assessment and interventions can be implemented.

Choice D Reason:

Forcing the intake of fluids may not be appropriate without further assessment and could potentially worsen the client's condition if there is an underlying gastrointestinal issue leading to absent bowel sounds. Additionally, forcing fluids may not address the potential issue of gastrointestinal bleeding.