A nurse is caring for a client who has multiple sclerosis and a new prescription for baclofen. Which of the following findings indicates the medication is having the desired effect?

Multiple sclerosis (MS) is a chronic demyelinating disorder of the central nervous system that leads to impaired nerve conduction, resulting in symptoms such as muscle spasticity, weakness, tremors, and decreased coordination. Management often includes medications that reduce muscle spasticity to improve mobility and function. Baclofen is a centrally acting muscle relaxant used to decrease spasticity by inhibiting excitatory neurotransmission in the spinal cord. Evaluating therapeutic effectiveness involves assessing improved motor function and reduced muscle rigidity. Rationale: A. Increased appetite is not a therapeutic effect of baclofen. This medication does not act on appetite-regulating centers in the brain. Changes in appetite are not indicators of improved spasticity or neuromuscular function in multiple sclerosis. B. Increased blood pressure is not a desired or expected effect of baclofen. In fact, baclofen may cause hypotension in some patients due to central nervous system depression. Blood pressure changes are not used to evaluate its effectiveness in reducing muscle spasticity. C. Improved dexterity indicates that muscle spasticity has decreased, allowing better voluntary movement and coordination. Baclofen works by reducing excitatory neurotransmission in the spinal cord, leading to decreased muscle tone and improved functional mobility. This improvement in fine motor control reflects the desired therapeutic outcome in a client with multiple sclerosis. D. Improved alertness is not a primary therapeutic effect of baclofen and may actually be contrary to its common side effects, which include sedation and drowsiness. The medication acts as a central nervous system depressant, so increased alertness would not be expected as a treatment goal indicator.