Discharge planning for a client with obsessive-compulsive disorder who is planning to go home tomorrow; which action is most appropriate?

• A. Hold discharge teaching in the morning and notify the health care provider of the findings
• B. Proceed with discharge teaching tonight
• C. Discharge home now
• D. Increase the medication dose today

Answer: (A)

The main idea here is ensuring the patient is ready to understand and carry out discharge instructions before leaving, with a plan that includes caregiver involvement and provider oversight. Holding discharge teaching until morning lets the client be rested and more capable of processing information, ask questions, and demonstrate understanding (teach-back). This timing reduces the risk of miscommunication about medications, follow-up appointments, safety plans, and warning signs, which is crucial for a condition like obsessive-compulsive disorder where anxiety and routine can affect engagement with new expectations.

Also, informing the health care provider about the findings from the morning teaching ensures any concerns—such as incomplete understanding, persistent symptoms, or safety risks—are addressed before discharge, allowing for any necessary adjustments in the plan.

Why the other options fit less well: teaching this evening may be less effective if the client is fatigued, which can impair learning and retention. Discharging home now would cut against the planned timeline and may be unsafe if the client hasn’t been adequately assessed or educated. Increasing the medication dose today without an order could cause harm and is outside the nurse’s scope, since dose changes require provider authorization.