A nurse is providing teaching about the administration of gastrostomy tube feedings to the parents of an infant. Which of the following instructions should the nurse include?

Rationale:
A. Advise the client to wait 1 hr before showering or swimming: Testosterone gel should be allowed to fully absorb into the skin before washing or swimming, typically waiting at least 1 hour. This ensures optimal absorption and therapeutic effect.

B. Instruct the client to have his testosterone checked in 1 week: Testosterone levels are generally evaluated after several weeks of therapy to assess effectiveness, not after just one week.

C. Wear clean gloves to apply the gel: The client should apply the medication themselves using clean, dry hands. The nurse should wear gloves only if assisting to prevent unintentional hormone absorption.

D. Apply the gel to the client's genital region: Testosterone gel should not be applied to the genitals due to increased absorption risk and skin irritation. Recommended sites include shoulders, upper arms, or abdomen.

Rationale:
A. Walk with feet close together for stability: Walking with feet close together increases the risk of loss of balance and falls in clients with multiple sclerosis (MS). A wider stance provides greater stability and a safer base of support when ambulating.

B. Implement a rigorous range-of-motion exercise plan: While exercise is beneficial, a rigorous plan can lead to fatigue and exacerbate MS symptoms. Activities should be moderate and spaced with rest periods to prevent overexertion, which can worsen weakness and spasticity.

C. Use a cane for support while walking: Using a cane provides additional balance and stability, helping to prevent falls. Clients with MS often experience muscle weakness and impaired coordination, so assistive devices like canes or walkers promote safe mobility and independence.

D. Avoid the use of orthotics: Orthotic devices can be very helpful for clients with MS who experience foot drop or lower extremity weakness. Avoiding orthotics removes a potential source of support and increases the risk of tripping and falling during ambulation.