A nurse in a substance use disorder clinic is explaining the alcohol recovery process to a client's family. Which of the following should the nurse identify as the first step toward successful recovery from alcohol use disorder?

A. Fluoxetine is not indicated for the treatment of seizures. Its primary therapeutic effect is related to mood stabilization through serotonin reuptake inhibition in the brain. Therefore, absence of seizures would not be an expected outcome of fluoxetine therapy.
B. Hand tremors are not typically a direct symptom of depression or anxiety but can occur as a side effect of certain medications or due to anxiety-related physiological responses. Fluoxetine itself does not typically cause or treat hand tremors directly. Therefore, while tremor reduction might occur as a result of improved mood and reduced anxiety, it is not a direct therapeutic outcome of fluoxetine.
C. Improved mood is one of the primary expected outcomes of fluoxetine therapy. SSRIs like fluoxetine work by increasing serotonin levels in the brain, which helps regulate mood and alleviate symptoms of depression and anxiety. Clients typically experience a reduction in feelings of sadness, hopelessness, and anxiety, leading to an overall improvement in mood.
D. Hallucinations are not a typical symptom of depression or anxiety disorders but can occur in conditions such as schizophrenia or psychotic depression. Fluoxetine is not primarily indicated for treating hallucinations.

A. Verbal de-escalation involves using calm, non-confrontational communication techniques to help calm the client. This can include speaking softly, using non-threatening body language, and actively listening to the client's concerns. It is the first-line intervention for managing escalating behavior because it aims to reduce agitation without the use of physical or chemical restraints.
B. Haloperidol is an antipsychotic medication that may be prescribed for acute agitation and aggression in some situations. However, obtaining a prescription requires provider authorization and should not be the first intervention unless the client's agitation poses an immediate threat to safety and verbal de- escalation has been ineffective. It is typically used when other interventions have not successfully managed agitation.

C. Physical restraints should only be used as a last resort and in accordance with institutional policies and legal guidelines. Restraints are intended to prevent harm to the client or others when all other methods of de-escalation have failed and there is an imminent risk of harm. Placing a client in restraints without attempting verbal de-escalation first can escalate the situation further.
D. Seclusion is also a restrictive intervention that should be used judiciously and only when necessary to protect the client or others from harm. It involves placing the client in a designated, secure area where they can be monitored closely. Similar to physical restraints, seclusion should be considered only after attempts at verbal de-escalation have been unsuccessful and there is a clear risk of harm.