A client who has been discharged home on citalopram calls the nurse complaining that the medication causes her to feel too drowsy. The nurse should make which of the following suggestions?

Choice A reason:This is incorrect because disulfiram does not reduce cravings for alcohol. Its mechanism of action is based on creating an aversive reaction when alcohol is consumed, not on suppressing the desire to drink. Medications such as naltrexone or acamprosate are used to reduce cravings, but disulfiram works differently.

Choice B reason:This is inaccurate because alcohol will still exert its effects when consumed. Disulfiram does not block alcohol’s pharmacological action; instead, it interferes with alcohol metabolism, leading to accumulation of acetaldehyde, which causes unpleasant symptoms.

Choice C reason:This is incorrect because disulfiram does not reverse alcohol’s effects. It does not act as an antidote. Instead, it causes a toxic reaction when alcohol is ingested, making drinking highly unpleasant and dangerous.

Choice D reason:This is correct because disulfiram inhibits aldehyde dehydrogenase, leading to accumulation of acetaldehyde when alcohol is consumed. This results in severe reactions such as throbbing headache, nausea, vomiting, flushing, hypotension, and palpitations. The reaction can be dangerous and is intended to deter alcohol consumption.

Choice A reason: Monitoring for tremors is important in opioid withdrawal but not the essential assessment before clonidine administration. Tremors are a symptom of withdrawal, but clonidine’s primary risk is hypotension, so blood pressure monitoring is more critical.

Choice B reason: Determining when the client last used an opiate helps in understanding withdrawal progression but does not directly influence clonidine safety. The timing of last opioid use is useful for clinical context but not the most essential assessment before giving clonidine.

Choice C reason: Completing a thorough physical assessment is a general nursing responsibility but is too broad to be considered the essential step before clonidine administration. While important, it does not specifically address the main safety concern of clonidine.

Choice D reason: Assessing blood pressure is the most essential nursing assessment before giving clonidine. Clonidine is an antihypertensive that lowers blood pressure by reducing sympathetic outflow. In opioid withdrawal, clonidine is used to reduce autonomic symptoms, but it can cause hypotension. Therefore, checking blood pressure ensures the client is safe to receive the medication and prevents complications such as severe hypotension or syncope.