A nurse is reinforcing teaching with a client about crutch walking using the swing-through gait. Which of the following statements should the nurse include?

Choice A rationale The swing-through gait is an advanced crutch-walking technique used by clients with good upper body strength and balance. It involves moving both crutches forward simultaneously and then swinging the entire body past the crutches to land ahead of them. This method allows for rapid movement but requires significant coordination. The nurse must emphasize that the body moves beyond the crutches, distinguishng it from the swing-to gait where the feet only reach the level of the crutches. Choice B rationale This description refers to the four-point or two-point gait, which provides maximal stability and mimics the natural rhythm of walking. In these gaits, the weight is distributed between the crutches and the feet in a sequential manner. This is inappropriate for a client instructed on the swing-through gait, as the mechanics are fundamentally different. The swing-through gait requires bilateral movement of the crutches followed by a forceful propulsion of the body, rather than alternating steps. Choice C rationale Clients should be instructed to look forward and maintain an upright posture rather than looking down at their feet. Looking down shifts the center of gravity forward, increasing the risk of falls and reducing environmental awareness. Proper proprioception and balance are maintained by focusing on the path ahead. Promoting a forward gaze ensures the client can navigate obstacles safely and maintains the spinal alignment necessary for efficient use of crutches during the swing phase. Choice D rationale Bearing weight on the axillary or underarm pads is strictly contraindicated because it can cause nerve damage to the brachial plexus. Clients must be taught to support their weight using the handgrips, keeping a space of approximately 2 to 3 finger-widths between the axilla and the crutch pad. Normal brachial nerve function is essential for arm strength and sensation. Pressure on the axilla can lead to crutch palsy, characterized by weakness or tingling in the hands.