The nurse teaches a client with MS to prevent fatigue. Which statements by the client indicate effective teaching? SELECT ALL THAT APPLY

Rationale: A. MS patients are sensitive to increases in body temperature due to Uhthoff’s phenomenon, where heat slows nerve conduction in demyelinated neurons. Exposure to heat, hot baths, or hot weather can temporarily worsen fatigue, weakness, and other neurologic symptoms. Avoiding these triggers demonstrates understanding of environmental strategies to minimize fatigue. B. Attempting to complete all tasks in one session leads to overexertion, which can worsen fatigue and increase the risk of injury or symptom flare-ups. Effective fatigue management involves energy conservation, such as breaking tasks into smaller steps, using adaptive devices, and pacing activities throughout the day. This statement indicates misunderstanding of energy conservation principles. C. While moderate exercise improves strength and endurance, exercising while fatigued can worsen symptoms, increase risk of falls or injury, and lead to burnout. Patients with MS should follow graded exercise programs and rest as needed, balancing activity with recovery periods. This statement shows a lack of understanding about pacing and self-monitoring. D. Scheduling short rest periods between tasks conserves energy and reduces cumulative fatigue. This approach allows patients to complete ADLs safely and maintain functional independence, demonstrating comprehension of effective energy management strategies. E. Maintaining a structured routine that alternates activity and rest supports overall energy management, prevents exacerbation of fatigue, and allows for sustained participation in daily activities. This demonstrates understanding of pacing strategies recommended for MS fatigue management.