A nurse is caring for a client who has Charcot-Marie-Tooth disease (CMT). Which of the following statements by the client indicates a need for further teaching?

Choice A reason:

This is a correct answer. Low back pain that radiates down the leg is a common symptom of radiculopathy due to a herniated intervertebral disc in the lumbar spine. Radiculopathy is a condition that affects the nerve roots that exit from the spinal cord, causing pain, numbness, tingling, or weakness along their distribution. A herniated intervertebral disc is a common cause of radiculopathy, as it can compress or irritate the nerve roots in the spinal canal or intervertebral foramen. The pain may follow a dermatomal pattern depending on which nerve root is affected.

Choice B reason:

This is a correct answer. Muscle weakness or atrophy in the affected leg is another common symptom of radiculopathy due to a herniated intervertebral disc in the lumbar spine. Muscle weakness or atrophy may result from reduced nerve stimulation or innervation to the muscles in the leg, which can affect their function and appearance. The muscle weakness or atrophy may follow a myotomal pattern depending on which nerve root is affected.

Choice C reason:

This is a correct answer. Diminished or absent deep tendon reflexes in the affected leg is another common symptom of radiculopathy due to a herniated intervertebral disc in the lumbar spine. Deep tendon reflexes are involuntary responses that are elicited by tapping on specific tendons with a reflex hammer, such as the patellar or Achilles tendon. Diminished or absent deep tendon reflexes may indicate damage or dysfunction of the nerve roots that mediate the reflex arc. The diminished or absent deep tendon reflexes may follow a segmental pattern depending on which nerve root is affected.

Choice D reason:

This is a correct answer. Positive straight leg raise test on the affected side is another common symptom of radiculopathy due to a herniated intervertebral disc in the lumbar spine. The straight leg raise test is a physical examination maneuver that involves raising the client's leg while keeping it straight and flexing the foot. A positive test is indicated by pain in the low back or leg that is reproduced or worsened by the maneuver, which suggests nerve root compression or irritation by the herniated disc.

Choice E reason:

This is an incorrect answer. Loss of bladder or bowel control is not a common symptom of radiculopathy due to a herniated intervertebral disc in the lumbar spine. Loss of bladder or bowel control may indicate cauda equina syndrome, which is a rare but serious condition that involves compression of the nerve roots at the end of the spinal cord, causing severe low back pain, saddle anesthesia, sexual dysfunction, and urinary or fecal incontinence. Cauda equina syndrome requires immediate medical attention and surgical decompression to prevent permanent nerve damage or paralysis.

Choice A reason:

This is an incorrect answer. The client does not need further teaching if they say they will wear braces or splints to support their feet and ankles. Braces or splints are helpful devices for clients who have CMT, which is a hereditary disorder that affects the peripheral nerves and causes muscle weakness, atrophy, and deformity in the feet, legs, hands, and arms. Braces or splints can improve mobility, stability, and alignment of the affected limbs.

Choice B reason:

This is an incorrect answer. The client does not need further teaching if they say they will avoid strenuous exercise and heavy lifting. These activities can worsen the symptoms and progression of CMT, as they can cause fatigue, injury, or overuse of the weakened muscles and nerves. The client should engage in moderate exercise and physical therapy that are tailored to their abilities and needs.

Choice C reason:

This is a correct answer. The client needs further teaching if they say they will take vitamin B12 supplements to prevent nerve damage. Vitamin B12 deficiency can cause peripheral neuropathy, which is a condition that affects the peripheral nerves and causes numbness, tingling, pain, or weakness in the extremities. However, vitamin B12 supplements do not prevent or treat CMT, which is a genetic disorder that affects the structure and function of the peripheral nerves.

Choice D reason:

This is an incorrect answer. The client does not need further teaching if they say they will inspect their feet daily for any injuries or infections. This is an important self-care measure for clients who have CMT, as they may have reduced sensation, circulation, or healing in their feet due to nerve damage. The client should inspect their feet daily and report any abnormalities to their provider.