A nurse is reinforcing teaching with the parents of a child who has hemophilia about the care of an injury that causes bleeding. Which of the following instructions should the nurse include in the teaching?

A. Encourage the parent to discuss the diagnosis with the adolescent immediately: While open communication is important, it is not always appropriate to encourage an immediate discussion, especially if the parent is struggling emotionally. The nurse should support the parent first in managing their emotions and in preparing for a discussion with the adolescent when the time is right.

B. Support the parent in expressing their concerns about the diagnosis and provide emotional support: The nurse should recognize the emotional difficulty the parent is experiencing and offer support. This includes helping the parent explore how to communicate difficult news to their child in an appropriate manner, providing counseling, and ensuring they have the resources to cope with the situation.

C. Inform the adolescent about the metastasis of cancer directly without the parent’s involvement: This option would not respect the parent’s role in communication and may cause unnecessary distress. It is important to involve the parent in the conversation, as they are likely the primary support for the adolescent and may need guidance on how to handle the situation.

D. Suggest to the parent to delay the conversation until the adolescent is physically stable: While not ideal, delaying the conversation until the adolescent is in a more stable emotional or physical state may be beneficial. The nurse can help guide the parent through the decision-making process and assist in determining the best timing for this sensitive discussion, emphasizing the need for a compassionate and supportive approach.

A. Hyperactive bowel sounds is incorrect. Sepsis is often associated with decreased gastrointestinal motility, leading to hypoactive or absent bowel sounds rather than hyperactivity.

B. Disorientation is correct. Mental status changes, such as confusion, irritability, or disorientation, can be an early sign of sepsis due to systemic infection and inadequate oxygenation.

C. Hypoglycemia is incorrect. Sepsis is more commonly associated with hyperglycemia due to the body's stress response. However, prolonged sepsis and organ dysfunction can eventually lead to hypoglycemia in later stages.

D. Polyuria is incorrect. In sepsis, fluid shifts and decreased organ perfusion often lead to oliguria (decreased urine output), not increased urination.