A nurse is caring for a client who reports continuing problems related to migraines. The nurse is assessing the psychosocial impact of migraines on the client. Which of the following questions should the nurse include in the assessment?
(Select All that Apply.)

Choice A Reason:

Manual wheelchair is inappropriate. A manual wheelchair requires the use of the client's upper extremities to propel the wheelchair forward by pushing on the wheels. With a spinal cord injury at the fourth cervical level, the client may have limited or no function in their upper extremities, making it difficult to self-propel a manual wheelchair.

Choice B Reason:

Sip-and-puff device is appropriate. A sip-and-puff device allows individuals with limited or no hand function to control a powered wheelchair using their breath. This device enables the client to navigate the wheelchair by inhaling or exhaling into a straw-like device, which activates controls to move the wheelchair forward, backward, and turn.

Choice C Reason:

Drive-adapted wheelchair is inappropriate. A drive-adapted wheelchair is a powered wheelchair that can be modified with adaptive controls to accommodate individuals with limited hand function or mobility. These wheelchairs may include joystick controls, head arrays, chin controls, or other adaptive devices that allow the client to operate the wheelchair independently despite limited hand function.

Choice D Reason:

Ultra-light wheelchairs is inappropriate. Ultra-light wheelchairs are manual wheelchairs that are lightweight and often customized to fit the client's specific needs and preferences. While ultra-light wheelchairs may offer advantages in terms of maneuverability and ease of transportation, they still require sufficient upper extremity function to self-propel the wheelchair.

Choice A Reason:

COPD is a chronic lung condition characterized by airflow limitation that is not fully reversible. Individuals with COPD often have underlying structural lung changes, such as emphysematous bullae or blebs. These areas of weakened lung tissue are prone to rupture, leading to the development of pneumothorax. Additionally, the chronic inflammation and damage to the airways and lung parenchyma in COPD contribute to the development of pneumothorax.

Choice B Reason:

Sarcoidosis is incorrect. Sarcoidosis is a granulomatous disease that primarily affects the lungs and lymph nodes. While it can cause lung damage and lead to pneumothorax, it is less common than COPD as a comorbidity associated with SSP.

Choice C Reason:

Lung cancer is incorrect. Lung cancer can lead to pneumothorax, especially if the tumor erodes into the pleural space. However, SSP is more commonly associated with underlying lung diseases like COPD rather than lung cancer.

Choice D Reason:

Cystic fibrosis is incorrect. Cystic fibrosis is a genetic disorder characterized by abnormal mucus production and impaired clearance in various organs, including the lungs. While individuals with cystic fibrosis are at increased risk of pneumothorax due to underlying lung disease, SSP is less commonly seen in this population compared to COPD.