A 4-month-old infant is seen at the ambulatory care clinic and diagnosed with nasolacrimal duct obstruction. The mother asks what can be done. What information should be included in the information provided to the parent?

A. Growth hormone therapy is typically administered daily, not weekly. Parents or caregivers are usually trained to give the injections at home, which encourages adherence and consistent growth hormone levels. Reliance on a home health nurse for weekly administration would be inadequate and inconsistent with standard therapy.

B. Routine urine monitoring is not a standard requirement for somatropin therapy. Monitoring is more focused on growth parameters (height, weight), blood glucose, thyroid function, and potential side effects like edema or joint pain. Proteinuria is not a common concern unless other renal complications exist.

C. Somatropin is a peptide hormone, which is degraded in the gastrointestinal tract if taken orally. Therefore, it must be administered via subcutaneous or sometimes intramuscular injection to ensure proper absorption and therapeutic effect. Parents should be taught proper injection technique, site rotation, needle disposal, and storage of the medication (usually refrigerated).

D. While growth hormone is naturally secreted in a pulsatile manner, and some clinicians may schedule injections in the evening to mimic normal secretion, there is no strict requirement for morning administration before school. Timing is flexible as long as injections are consistent daily, and some children may benefit from evening dosing.

A. There is no dietary restriction related to milk or dairy products for children with Wilms tumor. Nutritional support is important to maintain growth and healing, especially before and after surgery. This instruction is irrelevant and does not address the critical safety concern.

B. This is the priority nursing action for safety. The sign serves as a visible reminder to all staff, visitors, and caregivers to avoid any abdominal pressure or palpation. Nurses also instruct parents not to handle the child roughly or perform routine abdominal exams before surgery. This intervention significantly reduces the risk of preoperative complications and tumor spread.

C. While IM injections may cause minor bruising or bleeding, they do not increase the risk of tumor rupture. The priority concern is protecting the tumor itself, not avoiding IM injections. Injections may be given safely in other sites as necessary.

D. Venipuncture location does not affect tumor safety. Blood samples can be drawn from upper extremities without increasing the risk of rupture or metastasis. Restricting lower extremity sampling is not a standard precaution for Wilms tumor.