A nurse is planning to discharge a client who has quadriplegia to his home. The nurse suggests that the family might need respite care services. When a family member asks how respite care can help, which of the following responses should the nurse provide?

A. Methotrexate can cause myelosuppression, leading to low platelet counts (thrombocytopenia), which increases the risk of bleeding. Checking the platelet count will help assess whether the bleeding gums are related to low platelet levels and determine the need for further intervention.
B. An electric toothbrush can be gentler on the gums and may help reduce trauma to the oral mucosa, which can help minimize bleeding. However, while it is a good practice, it is not the immediate priority compared to checking the platelet count.
C. This action may be appropriate, especially if the bleeding persists or is severe. A dental evaluation is important to rule out any underlying dental issues that could be causing the bleeding gums. However, this should not be the first response without first assessing the cause of the bleeding, such as checking the platelet count.
D. While some degree of bleeding may occur due to thrombocytopenia associated with methotrexate, it
is not appropriate to dismiss the client’s symptoms as merely an expected effect. Bleeding gums can indicate a serious issue, and it’s important to take such complaints seriously and investigate the underlying cause.

A. A manual wheelchair would not be appropriate for a client with a C4 spinal cord injury. At this level, the client typically has significant loss of motor function and limited ability to propel a manual wheelchair due to weakness in the upper extremities. Therefore, this option is not suitable.
B. A sip-and-puff device allows clients with limited mobility to control a powered wheelchair by inhaling or exhaling into a straw-like device. For a client with a C4 injury, this is a feasible mobility solution that enables independence without the need for significant upper body strength.
C. Ultra-light wheelchairs are designed for individuals who have the strength and ability to propel themselves or those who need minimal assistance. However, a client with a C4 spinal cord injury would likely lack the strength needed for an ultra-light wheelchair, making this option inappropriate.
D. A drive-adapted wheelchair can be customized for individuals with various disabilities, including those with limited mobility. However, while it can be suitable for higher-level injuries (like C4), it would depend on the client's overall condition and whether they have the ability to operate controls, often using adaptive technology.