A nurse is reinforcing teaching with a parent whose preschooler has sleep disturbances. Which of the following instructions should the nurse include?

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.

Supporting families of clients newly diagnosed with depression involves therapeutic communication that promotes understanding, reduces anxiety, and assesses knowledge gaps. Depression is a complex mental health condition influenced by biological, psychological, and social factors, and recovery timelines vary widely depending on severity, treatment adherence, and individual response to therapy. Nurses should avoid giving false reassurance or vague predictions and instead engage the family in dialogue that helps tailor education to their needs. Effective communication strengthens coping and improves support for the client.

Rationale:
A. Providing generalized statements about improvement in other clients is non-therapeutic because it may create unrealistic expectations and does not address the partner’s specific concerns. Each client’s response to treatment for Major depressive disorder is individualized, so comparing outcomes can be misleading and unhelpful.

B. Stating that no one knows the answer may be truthful but is abrupt and non-therapeutic. It can increase anxiety and leave the partner without support or direction. Nursing communication should remain supportive while guiding the family toward understanding and coping.

C. Focusing only on the importance of improvement minimizes the partner’s concern about prognosis and does not provide education or emotional support. This type of response may shut down further discussion and fail to address the family’s need for information about recovery expectations.

D. Asking what the partner knows about depression is a therapeutic communication technique that assesses baseline understanding and allows the nurse to provide individualized education. It encourages dialogue, clarifies misconceptions, and supports emotional processing. This approach fosters engagement and helps build a realistic understanding of recovery.