A nurse is observing the gait of a client who uses crutches and has been taught to use a three-point gait. Which of the following actions places the client at risk for injury?

Crutch walking is a mobility skill that requires coordination, upper body strength, and strict adherence to weight-bearing restrictions to prevent falls and further injury. The three-point gait is specifically used for clients who are non-weight-bearing or partial weight-bearing on one affected extremity. Proper technique involves moving the assistive devices in a sequence that provides a stable base of support, particularly during high-risk maneuvers such as navigating stairs or transitioning from a seated to a standing position. Rationale: A. Holding the crutches on the unaffected side when rising from a chair is a correct and safe technique. The client should grasp both crutches by the handgrips using the hand on the side of the "good" leg while using the other hand to push off the armrest of the chair. This provides a stable pivot point and ensures that the crutches are immediately available for balance once the client is upright. Doing otherwise could provide an unstable support base during the transition. B. Putting the entire body weight on the unaffected leg is the fundamental requirement of a three-point gait. In this gait pattern, the affected leg is either kept off the ground entirely or used only for balance, while the weight is transferred between the crutches and the strong, unaffected leg. This ensures that the injured or post-surgical site is protected from mechanical stress, facilitating proper healing while still allowing the client to maintain functional mobility. C. Placing the affected leg on a step first when going up stairs is a dangerous error that significantly increases the risk of a fall. The correct sequence for ascending stairs is "up with the good": the client should step up with the unaffected leg first, then bring the crutches and the affected leg up to the same step. By stepping up with the affected leg first, the client would be forced to put weight on the injured limb or lack the necessary power to lift their body weight, leading to instability and potential injury. D. Advancing both crutches and the affected leg at the same time is the correct standard movement for the three-point gait. This creates a tripod effect where the weight is momentarily supported by the crutches while the unaffected leg is swung through or stepped forward. This sequence maintains balance and ensures that the affected limb is never required to support the body's weight independently.