A client is receiving rehabilitation for paralysis following a spinal cord injury and is diagnosed with reflex incontinence. Which of the following is the highest priority intervention the nurse should include in the plan of care?

Choice A reason: Mitral valve disease is not a disorder that makes clients especially vulnerable to ozone effects, as it does not affect the respiratory system. Mitral valve disease is a condition that affects the mitral valve, which is the valve that separates the left atrium and the left ventricle of the heart. Mitral valve disease can cause the valve to become narrow (stenosis) or leaky (regurgitation), affecting the blood flow and oxygen delivery to the body. Mitral valve disease can cause symptoms such as shortness of breath, fatigue, chest pain, palpitations, and swelling of the legs.

Choice B reason: Asthma is a disorder that makes clients especially vulnerable to ozone effects, as it affects the respiratory system. Asthma is a chronic inflammatory condition that causes the airways to become narrow, swollen, and sensitive to triggers such as allergens, irritants, infections, or exercise. Asthma can cause symptoms such as wheezing, coughing, chest tightness, and difficulty breathing. Ozone is a gas that is formed when sunlight reacts with pollutants in the air. Ozone can irritate the lungs and worsen asthma symptoms by causing inflammation, bronchoconstriction, and mucus production. Ozone can also reduce lung function and increase the risk of respiratory infections.

Choice C reason: Nasal polyps are not a disorder that makes clients especially vulnerable to ozone effects, as they do not affect the respiratory system. Nasal polyps are benign growths that form in the lining of the nose or sinuses. Nasal polyps can cause symptoms such as nasal congestion, runny nose, postnasal drip, loss of smell or taste, headache, and snoring. Nasal polyps are usually associated with chronic inflammation or allergies, but their exact cause is unknown.

Choice D reason: Seasonal allergies are not a disorder that makes clients especially vulnerable to ozone effects, as they do not affect the respiratory system. Seasonal allergies are allergic reactions that occur during certain times of the year when pollen or mold spores are high in the air. Seasonal allergies can cause symptoms such as sneezing, itching, watery eyes, runny nose, and sore throat. Seasonal allergies are caused by an overreaction of the immune system to harmless substances in the environment.

Choice A reason: Asking how they are managing at home is an appropriate action by the nurse. It shows respect and interest in the client's situation and helps to assess their needs, challenges, and goals.

Choice B reason: Going automatically into the client's bedroom is not an appropriate action by the nurse. It violates the client's privacy and autonomy and may make them feel uncomfortable or threatened. The nurse should ask for permission before entering any room in the client's home.

Choice C reason: Arranging mutual future visits is an appropriate action by the nurse. It demonstrates collaboration and commitment and helps to establish a trusting relationship with the client. It also allows the nurse to plan and coordinate the care and follow-up.

Choice D reason: Thanking the client for arranging a home visit is not an appropriate action by the nurse. It implies that the home visit is a favor or a burden, rather than a professional service that the client is entitled to. It may also undermine the nurse's authority and credibility.

Choice E reason: Sitting down and discussing with the client and family members is an appropriate action by the nurse. It indicates that the nurse values the client's perspective and input, and recognizes the family as an important source of support and information. It also facilitates communication and education and promotes shared decision-making.