A patient has a new order for a thoraco-lumbo-sacral orthosis (TLSO) to help support and stabilize her spine. What are the nursing priorities when caring for this patient? (Select all that apply)

Choice A reason: Ensuring proper fit of the TLSO is critical to stabilize the spine effectively, preventing further injury. An ill-fitting brace can cause misalignment, pressure sores, or reduced efficacy, as it fails to immobilize the thoracolumbar region, making this a key nursing priority. Choice B reason: How the patient sleeps with the brace is not a primary nursing priority. While comfort during sleep matters, the TLSO is typically worn as prescribed, and sleep position is secondary to ensuring fit, breathing, education, and skin care, making this choice incorrect. Choice C reason: Monitoring breathing is essential, as a TLSO can restrict chest expansion, potentially reducing tidal volume and causing respiratory distress. Nurses must assess respiratory rate and oxygen saturation to ensure the brace does not compromise ventilation, making this a critical priority. Choice D reason: Educating the patient and family about the TLSO’s purpose and care ensures compliance and proper use. Understanding how to wear, clean, and adjust the brace prevents complications like skin breakdown or ineffective stabilization, making this a key nursing responsibility. Choice E reason: Skin integrity is a priority, as prolonged brace use can cause pressure ulcers or irritation. Nurses must inspect skin under the TLSO regularly, ensuring proper padding and hygiene to prevent breakdown, especially in immobile patients, making this a critical care aspect.