A client is seeking treatment for a respiratory infection at a local clinic. During the visit, the client verbalizes concern about the cost of medication and the inability to pay for it. Which of the following responses should the nurse use?

Choice A Reason:

Weight loss is inappropriate. Weight loss can occur in individuals with COPD, particularly in advanced stages of the disease. Factors contributing to weight loss may include decreased appetite, increased energy expenditure due to labored breathing, and muscle wasting.

Choice B Reason:

Poor nutrition is inappropriate. Poor nutrition is a significant risk factor in COPD. Individuals with COPD may experience difficulties with eating due to dyspnea, fatigue, and reduced appetite. Malnutrition can lead to muscle weakness, decreased immune function, and worsened respiratory status.

Choice C Reason:

Muscle dysfunction is inappropriate: Muscle dysfunction, particularly skeletal muscle dysfunction, is common in COPD. Reduced physical activity, systemic inflammation, oxidative stress, and metabolic abnormalities contribute to muscle wasting and weakness in individuals with COPD.

Choice D Reason

.Increased risk for pneumonia is incorrect. Individuals with COPD are at an increased risk for respiratory infections, including pneumonia. COPD-related factors such as impaired mucociliary clearance, airway inflammation, and reduced lung function predispose patients to respiratory infections.

Choice A Reason:

Primary progressive multiple sclerosis (PPMS) is false. This subtype of MS is characterized by a gradual worsening of symptoms from the onset of the disease, without distinct relapses or remissions. It typically leads to a progressive accumulation of disability over time, without periods of remission. The pattern described by the client, with alternating periods of active symptoms and symptom-free periods, does not align with the continuous progression seen in PPMS.

Choice B Reason:

Relapsing-remitting multiple sclerosis (RRMS) is true. RRMS is characterized by distinct relapses, during which new symptoms may appear or existing symptoms may worsen, followed by periods of partial or complete recovery (remissions), during which the symptoms improve or may even disappear entirely. This pattern matches the description provided by the client, indicating RRMS as the likely subtype.

Choice C Reason:

Clinically isolating syndrome (CIS) is false. CIS refers to a single episode of neurological symptoms caused by inflammation or demyelination in the central nervous system, which may or may not progress to MS. However, CIS does not involve the characteristic pattern of relapses and remissions seen in RRMS.

Choice D Reason:

Secondary progressive multiple sclerosis (SPMS) is false. SPMS is characterized by a gradual worsening of symptoms and disability over time, following an initial period of relapsing-remitting disease. It may or may not involve distinct relapses and remissions, depending on the individual's disease course. While SPMS can involve periods of symptom exacerbation, it typically lacks the clear pattern of relapses followed by remissions seen in RRMS.