A nurse is teaching a client who has multiple sclerosis about factors that can worsen their manifestations. Which of the following factors should the nurse include in the teaching?

Choice A Reason:

Falls is correct. Among individuals aged 65 years and older, falls are the most common cause of spinal cord injuries. As people age, they may experience changes in balance, mobility, and bone density, which can increase their risk of falling. Falls can occur both at home and in other environments, such as during outdoor activities or in healthcare settings. Spinal cord injuries resulting from falls in older adults can have significant consequences, including decreased mobility, chronic pain, and loss of independence.

Choice B Reason:

Gunshot wounds is incorrect. Gunshot wounds can cause spinal cord injuries, but they are not the most common cause for individuals aged 65 years and older. Gunshot wounds tend to be more common in younger age groups or in specific contexts such as violence-related incidents, which are less frequent in older adults.

Choice C Reason:

Sporting accidents is incorrect. Sporting accidents can also lead to spinal cord injuries, especially in younger and more active individuals participating in high-impact sports. However, among individuals aged 65 years and older, participation in sporting activities that could result in spinal cord injuries is generally less common compared to younger age groups.

Choice D Reason:

Motor vehicle accidents is incorrect.

Motor vehicle accidents can cause spinal cord injuries, but they are not as common in the elderly population as they are in younger age groups. Older adults may have reduced driving frequency or may be more cautious on the road, which decreases their risk of motor vehicle accidents compared to younger individuals.

Choice A Reason:

Pupillary dilation is correct. Pupillary changes can indicate neurological dysfunction following a head injury. Dilated pupils may suggest increased intracranial pressure or damage to specific brain structures.

Choice B Reason:

Persistent headache is correct .Headaches are a common symptom following a head injury. Persistent or worsening headaches can indicate ongoing neurological issues and should be monitored closely.

Choice C Reason:

Presence of hand tremors is incorrect. Hand tremors are not typically associated with loss of consciousness following a motor vehicle accident. While hand tremors can occur in various conditions, such as essential tremor or Parkinson's disease, they are not typically a direct manifestation of a head injury. The primary concern immediately following a motor vehicle accident with loss of consciousness is assessing for signs of neurological dysfunction, such as altered level of consciousness, pupillary changes, and persistent headache. Hand tremors may be assessed in other contexts, but they are not directly related to the immediate assessment of a client following a motor vehicle accident with loss of consciousness.

Choice D Reason:

Difficulty waking is correct. Difficulty waking or altered level of consciousness can indicate neurological impairment and may be indicative of a concussion or other brain injury.

E. Foot drop is incorrect. Foot drop refers to difficulty lifting the front part of the foot, which can cause dragging of the foot or toes along the ground while walking. While foot drop can result from various neurological conditions or injuries, it is not typically associated with loss of consciousness following a motor vehicle accident. Loss of consciousness after a motor vehicle accident is more indicative of potential head trauma or concussion, which may present with symptoms such as altered level of consciousness, headache, pupillary changes, or difficulty waking. Foot drop would be more relevant to assess in contexts related to peripheral nerve injury, spinal cord injury, or neurological conditions affecting the lower extremities. Given the scenario provided, foot drop is not a typical manifestation that the nurse would assess for immediately following a motor vehicle accident with loss of consciousness. Therefore, option E is not relevant in this scenario.