A client with multiple sclerosis is voicing concerns to the nurse about incoordination when walking. Which of the following instructions by the nurse would be most appropriate at this time?

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Multiple sclerosis (MS) is a progressive, demyelinating disease of the central nervous system that interrupts nerve impulses, causing a variety of symptoms. Symptoms may vary, but muscle weakness, spasticity, incoordination, loss of balance, and fatigue are usually present, causing impaired mobility and risk for fall and injury. Walking with the feet apart increases the support base, improving steadiness and gait. Assistive devices, such as a cane or walker, are usually required as demyelination of the nerve fibers progresses. (Option A) Range-of-motion, strengthening, and stretching exercises help limit spasticity and contractures in clients with MS. (Option B) Fatigue is a common symptom with MS. Rather than increasing the duration, clients should balance exercise with rest. Clients should also exercise when the weather is cool and stay hydrated; dehydration and extremes in temperature cause symptom exacerbation. (Option C) Wheelchairs are advised only if exercise and gait training are not successful as clients should maintain mobility and independence as long as possible. Educational objective: Clients with multiple sclerosis experience fatigue, incoordination, balance impairment, muscle weakness, and muscle spasticity from demyelination of nerve fibers. Gait training (eg, walking with the feet apart) and assistive devices can help prevent falls and injury and preserve independence as long as possible.

A Client with Multiple Sclerosis Is Voicing Concerns to the Nurse