A nurse is reinforcing teaching with a client about the proper disposal of syringes who is prescribed insulin. Which of the following instructions should the nurse include in the teaching?

During disaster preparedness such as an incoming storm, nurses must prioritize hospital capacity for clients who require acute, unstable, or life-threatening care. Discharge planning focuses on identifying clients who are clinically stable, receiving routine or ongoing management, and can safely continue care at home or outpatient settings. High-acuity clients, those requiring intensive monitoring, or those with unstable vital signs should remain hospitalized. The goal is to free resources while maintaining patient safety during emergency situations.

Rationale:
A. A child with leukemia and an absolute neutrophil count of 200/mm³ is severely immunocompromised and at high risk for life-threatening infection. This level of neutropenia requires protective precautions and close inpatient monitoring. Discharging this client during a storm would place them at significant risk of sepsis and complications.

B. An infant with respiratory syncytial virus and a respiratory rate of 70/min indicates significant respiratory distress. This is a high-acuity finding suggesting potential respiratory failure or fatigue. Such a client requires hospitalization for oxygen support, suctioning, and close monitoring.

C. An adolescent with cystic fibrosis receiving a scheduled “tune-up” is appropriate for discharge consideration because this indicates a planned, non-urgent hospitalization for routine pulmonary therapy. Once stabilized, clients with Cystic fibrosis can often continue airway clearance therapies and medications at home or outpatient care. This makes them the most stable option among the choices during disaster planning.

D. A child with new-onset type 1 diabetes receiving IV insulin requires intensive monitoring for glucose stability and potential complications such as hypoglycemia or electrolyte imbalance. This is an unstable condition requiring inpatient care and education before safe discharge. Removing this client during a storm would increase risk of metabolic emergencies.

Blood glucose monitoring is a routine nursing procedure used to assess a client’s glycemic status and guide diabetes management. Accurate capillary blood sampling technique is essential to obtain reliable results while minimizing discomfort and tissue injury. Proper procedure also reduces the risk of infection and ensures adequate blood flow from the puncture site. Nursing care focuses on correct site selection, aseptic technique, and avoiding actions that may distort results.

Rationale:
A. Puncturing the side of the client’s finger is correct because this area has fewer nerve endings and is less painful compared to the fingertip center. It also provides adequate capillary blood flow for accurate glucose measurement. Proper site selection improves client comfort while ensuring reliable results during monitoring of conditions such as Blood glucose monitoring.

B. Positioning the client’s finger above the heart is incorrect because it reduces blood flow to the puncture site, making it more difficult to obtain an adequate blood sample. The finger should be kept in a dependent position or gently warmed to promote capillary perfusion. Elevation may lead to insufficient sample collection and repeated punctures.

C. Milking the finger site is incorrect because it can cause tissue fluid contamination of the blood sample, leading to falsely altered glucose readings. Excessive squeezing may dilute the sample with interstitial fluid, reducing accuracy. Gentle pressure may be used, but forceful “milking” should be avoided.

D. Applying sterile gloves is not required for routine blood glucose monitoring; clean gloves are appropriate. The procedure is considered non-sterile but requires standard precautions to prevent infection. Using sterile gloves unnecessarily increases cost and is not indicated for capillary blood sampling.