A nurse is teaching a client who has multiple sclerosis. Which of the following instructions should the nurse include in the teaching?

Rationale:
A. Elevate the affected forearm with pillows: Elevation helps reduce swelling and promotes venous return, which is critical in the immediate management of a fracture to prevent complications such as increased edema or impaired circulation.

B. Administer Ibuprofen 200 mg PO: The child reports pain at a level of 5, meeting the prescription threshold. Administering analgesia promptly helps manage discomfort and supports cooperation with further interventions, such as casting.

C. Place a nonadherent dressing on the right knee abrasion: While wound care is important, the abrasion is minor and not the most urgent concern. Prioritization focuses on the fractured limb and pain management.

D. Review cast care instructions with the child's parents: Education is important but is not the immediate priority before the cast is applied. It can be provided after the child is stabilized and pain is managed.

E. Explain the cast application procedure to the child: While preparing the child psychologically is important, immediate interventions to reduce pain and swelling take precedence over anticipatory teaching.

F. Apply ice packs to the fingers and along the right forearm: Ice helps reduce swelling and pain in the acute phase of the fracture. Applying ice in combination with elevation supports circulation and comfort while awaiting casting.

Rationale:
A. "Supplement breastfeedings with water every 12 hours.": Breastfed infants do not require water supplementation because breast milk provides adequate hydration. Giving water can reduce milk intake, interfere with nutrition, and increase the risk of electrolyte imbalance.

B. "Limit the time your infant feeds to 10 minutes on each breast.": Feeding duration should be guided by the infant’s cues rather than a strict time limit. Limiting feeds can prevent the infant from receiving the hindmilk, which is richer in fat and essential for growth.

C. "Begin each feeding using the same breast.": Alternating the starting breast for each feeding helps ensure equal stimulation and milk production in both breasts. Starting with the same breast consistently may lead to uneven milk supply.

D. "Offer your infant the breast when he shows signs of hunger.": Responsive, cue-based feeding supports adequate nutrition, growth, and bonding. Feeding on demand—such as rooting, sucking on hands, or fussiness—helps establish and maintain milk supply and meets the infant’s needs effectively.