The nurse has completed discharge instructions for a client with application of a halo device who sustained a cervical spinal cord injury. Which statement indicates that the client needs further clarification of the instructions?

A halo device is used to provide rigid immobilization of the cervical spine after cervical fractures or spinal cord injuries. It stabilizes the head and neck to promote healing and prevent further neurological damage. Client education focuses on safety, skin care, pin-site care, mobility precautions, and activity restrictions. Because the device limits neck movement and affects balance, certain daily activities such as driving become unsafe and require clear discharge teaching. A. Being careful because the device alters balance is an appropriate understanding of discharge teaching. A halo vest changes the client’s center of gravity and limits normal head movement, increasing the risk of falls. Clients should move slowly, use assistance when needed, and take precautions to prevent injury during ambulation and position changes. B. Carefully washing the skin under the brace daily is correct because skin breakdown can occur under the vest from pressure, moisture, and friction. Proper hygiene helps prevent infection and irritation, especially since the brace remains in place for extended periods. Skin care must be performed carefully without disturbing the alignment of the device. C. Using a straw when drinking is appropriate because the halo device restricts neck flexion and makes it difficult to tilt the head forward. A straw helps the client drink safely and comfortably without compromising cervical alignment. This adaptation supports independence while maintaining proper immobilization. D. Saying “I will drive only during the daytime” indicates a need for further teaching because clients with a halo device should not drive at all until cleared by the healthcare provider. Restricted neck movement limits the ability to safely turn the head, check blind spots, and react quickly to traffic conditions. Daytime driving does not remove these safety risks.