A nurse is caring for a client who has an upper cervical spinal cord injury and a halo device. Which of the following actions should the nurse take?

A. The halo device should never be used as a handle to reposition or turn the client. Doing so can disrupt spinal alignment, loosen pins, or cause injury. The nurse should use a log-rolling technique with assistance to reposition the client safely. B. The halo vest should fit snugly but not tightly. Being able to insert one finger between the vest and the client’s skin ensures adequate ventilation, prevents skin breakdown, and confirms proper fit without compromising immobilization. C. Inserting objects under the vest increases the risk of skin injury, infection, and pressure sores. If itching occurs, the nurse should use cool air from a hair dryer on a low setting or inspect the skin when the vest is removed by trained personnel. D. Only the provider or specially trained personnel should adjust or tighten halo pins. Improper tightening by nursing staff can cause infection, nerve injury, or skull penetration. Loose pins should be reported immediately.