A nurse is teaching a client who has a new prescription for sumatriptan (Imitrex) tablets to treat migraine headaches. Which of the following instructions should the nurse include?

Choice A reason: A skilled nursing facility is a type of long-term care facility that provides 24-hour nursing care and supervision for residents who need assistance with activities of daily living, such as bathing, dressing, eating, and toileting. A skilled nursing facility may not be suitable for a young client with multiple sclerosis who has the potential for improvement and recovery.

Choice B reason: Home care services are a type of community-based care that provides medical and personal care to clients in their own homes. Home care services may include nursing, physical therapy, occupational therapy, speech therapy, social work, or home health aide services. Home care services may be appropriate for a client with multiple sclerosis who has mild to moderate symptoms and a supportive family or caregiver.

Choice C reason: A rehabilitation facility is a type of short-term care facility that provides intensive physical and occupational therapy to clients who have functional impairments due to injury, illness, or surgery. A rehabilitation facility may also provide medical, nursing, and psychological care to clients who need them. A rehabilitation facility may be suitable for a client with multiple sclerosis who has significant muscle weakness and needs to regain strength, mobility, and independence.

Choice D reason: A sub-acute care facility is a type of transitional care facility that provides medical and nursing care to clients who are stable but need complex monitoring or treatment that cannot be provided at home or in a skilled nursing facility. A sub-acute care facility may also provide rehabilitation services to clients who need them. A sub-acute care facility may not be appropriate for a young client with multiple sclerosis who has the potential for improvement and recovery.

Choice A: Limit fluid intake to prevent incontinence. This is incorrect because limiting fluid intake can lead to dehydration, urinary tract infections, and kidney stones. Fluid intake should be adequate to maintain hydration and flush out bacteria from the urinary tract.

Choice B: Provide regular perineal care to prevent skin breakdown. This is correct because reflex incontinence can cause urine leakage and skin irritation, which can increase the risk of infection and pressure ulcers. Regular perineal care can help keep the skin clean and dry, and prevent complications.

Choice C: Administer hypotonic IV fluids. This is incorrect because hypotonic IV fluids can cause fluid overload, hyponatremia, and cerebral edema. Hypotonic IV fluids are not indicated for clients with reflex incontinence.

Choice D: Teach Kegel exercises to strengthen the pelvic floor. This is incorrect because Kegel exercises are effective for clients with stress or urge incontinence, but not for clients with reflex incontinence. Reflex incontinence is caused by a loss of voluntary control over the bladder due to a spinal cord injury, and Kegel exercises cannot restore this function.