A nurse is admitting a client who has an alcohol use disorder. Which of the following actions should the nurse take first?

Determine the client's degree of physical dependence.

Discuss the treatment plan with the client.

Document the client's alcohol use in the medical record.

Initiate a referral for treatment for alcohol use disorder.

Answer and Explanation

The Correct Answer is C

A. Determine the client's degree of physical dependence:
This action is important but usually comes after the initial assessment and documentation. Assessing the degree of physical dependence involves evaluating the client's withdrawal symptoms, tolerance, and other physical health parameters. It helps in planning the appropriate level of care, such as detoxification if needed.

B. Discuss the treatment plan with the client:
While discussing the treatment plan is crucial, it's typically done after gathering essential information about the client's alcohol use, medical history, and current condition. The treatment plan is tailored based on the gathered data, which includes documenting the client's alcohol use.

C. Document the client's alcohol use in the medical record:
This is the first step because it provides a formal record of the client's alcohol use history, including patterns and any associated complications. Documenting this information helps in comprehensive care planning and ensures that all healthcare providers involved in the client's treatment have accurate and up-to-date information.

D. Initiate a referral for treatment for alcohol use disorder:
Referrals are essential, but they usually follow the initial assessment and documentation. The referral process involves connecting the client with appropriate resources, such as addiction specialists, counselors, or support groups, based on the documented information and the client's needs.

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Correct Answer is C

Explanation

A. Naltrexone:
Naltrexone is an opioid receptor antagonist. It blocks the effects of opioids and alcohol in the brain. It's often used as part of a long-term treatment plan to prevent relapse in individuals who have already stopped drinking and are trying to maintain sobriety. Naltrexone does not directly manage acute alcohol withdrawal symptoms. Instead, it helps individuals reduce or quit drinking over the long term by reducing the pleasure associated with alcohol consumption.

B. Disulfiram:
Disulfiram is an aversion therapy medication used as a deterrent to drinking. When someone taking disulfiram consumes alcohol, it causes unpleasant physical reactions, such as nausea, flushing, and palpitations. This discourages individuals from drinking while they are on the medication. Disulfiram is not used to manage acute withdrawal symptoms but rather serves as a deterrent to drinking for individuals who are trying to maintain sobriety.

C. Lorazepam:
Lorazepam is a benzodiazepine medication that acts as a central nervous system depressant. It is commonly used to manage acute alcohol withdrawal symptoms. Benzodiazepines like lorazepam help to reduce anxiety, agitation, and the risk of seizures associated with alcohol withdrawal. They are typically used in a controlled manner to provide relief during the acute phase of withdrawal.

D. Acamprosate:
Acamprosate is used in the maintenance phase of alcohol use disorder treatment. It helps individuals maintain abstinence by stabilizing the chemical imbalances in the brain that occur after prolonged alcohol use. Acamprosate is not used for acute withdrawal management but is instead prescribed to support individuals who have already stopped drinking and are trying to avoid relapse over the long term.

A. Instruct the client to consume a low-sodium diet to decrease hand tremors. B. Teach the client to take the lithium in a single daily dose C. Contact the provider for a possible decrease in the lithium dosage. D. Encourage the client to take naproxen sodium to decrease tremors.

Correct Answer is C

Explanation

A. Instruct the client to consume a low-sodium diet to decrease hand tremors:
While maintaining a stable sodium intake is important for individuals taking lithium to avoid fluctuations in lithium levels, a low-sodium diet is not specifically indicated to address hand tremors caused by lithium. Adjusting sodium levels is more about maintaining a consistent intake to stabilize lithium levels over time.

B. Teach the client to take the lithium in a single daily dose:
Lithium is often prescribed in divided doses to maintain stable blood levels throughout the day and minimize side effects. However, the dosing regimen (once or multiple times a day) is usually determined by the healthcare provider based on the individual's needs. Changing the dosing frequency is not the primary intervention for managing hand tremors.

C. Contact the provider for a possible decrease in the lithium dosage:
Hand tremors are a common side effect of lithium. If a client is experiencing bothersome side effects within the therapeutic range, the appropriate action is to contact the healthcare provider. The provider can assess the situation, possibly adjust the dosage, or explore other management options to alleviate the tremors while maintaining the therapeutic effect of the medication.

D. Encourage the client to take naproxen sodium to decrease tremors:
Encouraging the client to take naproxen sodium or any other nonsteroidal anti-inflammatory drug (NSAID) is not recommended when the client is on lithium therapy. NSAIDs can interact with lithium, potentially leading to increased lithium levels and toxicity. Combining these medications should be avoided.

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A nurse is admitting a client who has an alcohol use disorder. Which of the following actions should the nurse take first?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has alcohol use disorder and is experiencing acute withdrawal. Which of the following medications should the nurse expect to administer first?

Correct Answer is C

Explanation

A nurse in a community mental health clinic is assessing a client who began taking lithium carbonate 5 days ago. The client reports fine hand tremors and has a current lithium level of 1.2 mEq/L. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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