A nurse is teaching a client who has a new prescription for sumatriptan (Imitrex) tablets to treat migraine headaches. Which of the following instructions should the nurse include?

Choice A reason: Providing total assistance with all ADLs is not an intervention that should be included in the client's plan. ADLs are activities of daily living, such as bathing, dressing, eating, and toileting. Providing total assistance with all ADLs can reduce the client's independence and self-esteem, and increase their dependence and learned helplessness. The nurse should encourage and assist the client to perform as much as they can by themselves and provide partial or intermittent assistance only when needed.

Choice B reason: Ordering a low-residue diet is not an intervention that should be included in the client's plan. A low-residue diet is a type of diet that limits foods that are high in fiber or indigestible material, such as whole grains, nuts, seeds, fruits, and vegetables. A low-residue diet may be recommended for clients who have inflammatory bowel disease (IBD), diverticulitis, or bowel obstruction, as it can reduce bowel frequency and irritation. However, it is not indicated for clients who have MS, unless they have other comorbidities that require it. A balanced diet that includes adequate fiber, fluids, and nutrients is more beneficial for clients who have MS.

Choice C reason: Encouraging the client to void every hour is not an intervention that should be included in the client's plan. Voiding every hour can be inconvenient and impractical for the client, and may not address their bladder problems effectively. MS can cause bladder dysfunction, such as urinary urgency, frequency, incontinence, or retention, due to nerve damage that affects bladder control. The nurse should assess the type and severity of the bladder dysfunction, and provide appropriate interventions, such as medication, catheterization, pelvic floor exercises, or bladder training.

Choice D reason: Instructing the client on daily muscle stretching is an intervention that should be included in the client's plan. Muscle stretching is a type of exercise that involves extending or elongating a muscle or group of muscles to their full length. Muscle stretching can help prevent or relieve muscle spasticity, stiffness, pain, or contractures that may occur in clients who have MS. The nurse should teach the client how to perform muscle stretching safely and correctly, and encourage them to do it daily or as prescribed.

Choice A: Collaborate with a physical therapist to develop programs for injured employees to return to work. This is incorrect because this is a tertiary prevention strategy, not a secondary prevention strategy. Tertiary prevention aims to restore function and prevent disability or complications after an injury or illness has occurred.

Choice B: Help plant workers identify signs of carpal tunnel syndrome. This is correct because this is a secondary prevention strategy. Secondary prevention aims to detect and treat health problems early before they become more serious or chronic. Carpal tunnel syndrome is a common occupational health problem that can cause pain, numbness, and weakness in the hand and wrist. Early identification and treatment can prevent permanent nerve damage and disability.

Choice C: Organize an influenza immunization campaign. This is incorrect because this is a primary prevention strategy, not a secondary prevention strategy. Primary prevention aims to prevent disease or injury from occurring in the first place, by reducing exposure or risk factors. Influenza immunization can protect plant workers from getting infected by the flu virus and reduce the spread of the disease.

Choice D: Teach plant workers about proper lifting techniques. This is incorrect because this is also a primary prevention strategy, not a secondary prevention strategy. Proper lifting techniques can prevent musculoskeletal injuries such as sprains, strains, and herniated discs, by avoiding excessive stress on the spine and joints.