A nurse is teaching a group of parents about car seat safety. Which of the following statements should the nurse include in the teaching?

Rationale for correct choice

• Fall risk: The client experiences sudden episodes of leg weakness, intermittent muscle spasms, and gait changes, all of which significantly increase the risk of falls. Falls in clients with multiple sclerosis can lead to serious injury and further functional decline. Addressing safety and fall prevention is the most immediate priority to prevent harm while other concerns, such as memory or employment, are addressed.

Rationale for incorrect choices

• Memory: Although the client reports struggling to remember things, cognitive issues are not immediately life-threatening. Memory deficits should be addressed through ongoing assessment and cognitive support interventions, but they are not the first priority compared with safety risks.

• Blood pressure: Vital signs are within normal limits, and there is no evidence of hypertensive crisis or acute cardiovascular instability. Blood pressure monitoring remains part of routine care but does not require immediate intervention.

• BMI: The client’s BMI indicates overweight status but does not pose an immediate safety threat. Weight management is important for long-term health but is not the first priority in the context of neurological deficits and fall risk.

• Employment: Reduced work hours due to exacerbation episodes reflect functional limitations and psychosocial impact. Employment concerns are important for quality of life but are secondary to preventing physical injury from falls.

A. "You should push the button before physical activity to allow maximum pain control.": Preemptively using the PCA before activities such as ambulation or physical therapy helps prevent breakthrough pain, allowing the client to perform activities more comfortably. This approach maximizes the effectiveness of pain control.

B. "Continuous PCA infusion is designed to allow fluctuating plasma medication levels.": Continuous PCA is designed to maintain consistent plasma levels of medication, not fluctuating levels. This ensures steady pain control rather than peaks and troughs.

C. "You can adjust the amount of pain medication you receive by pushing on the keypad.": Clients cannot override the preset dosage limits on a PCA pump. The device is programmed by the healthcare provider to deliver safe doses, so self-adjusting the amount is not permitted.

D. "The PCA will deliver a double dose of medication when you push the button twice.": PCA pumps have lockout intervals to prevent overdosing. Pressing the button multiple times during the lockout period will not deliver extra doses, so this statement is incorrect and could be dangerous if misunderstood.