A nurse is caring for a client who asks for information about advance directives and states, “I want to make sure my wishes are respected.” Which of the following responses should the nurse make?

Choice A reason: Disulfiram is an oral medication, not injectable, used to deter alcohol consumption by causing adverse reactions. Monthly injections apply to drugs like naltrexone, not disulfiram, which requires daily oral dosing to maintain its deterrent effect in alcohol use disorder treatment.
Choice B reason: Taking disulfiram before quitting alcohol is incorrect, as it is started post-abstinence to prevent relapse. Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde buildup if alcohol is consumed, making it effective only in alcohol-free clients to deter drinking.
Choice C reason: Avoiding over-the-counter medications with alcohol is correct, as disulfiram causes severe reactions (nausea, flushing) with alcohol ingestion, including from medications like cough syrups. This reflects understanding of disulfiram’s mechanism, ensuring safety by preventing unintended alcohol exposure.
Choice D reason: Continuing disulfiram for 5 years is not standard, as duration varies per treatment plan. Disulfiram supports early abstinence, not fixed long-term use. This statement misrepresents its role, as therapy length depends on individual recovery needs, not a predetermined timeframe.

Choice A reason: Maternal fever may cause fetal tachycardia, not bradycardia, as it increases metabolic demand. While fever can indicate infection, it does not directly lower FHR to 100/min, making it an incorrect cause for sustained fetal bradycardia in this scenario.
Choice B reason: Chorioamnionitis, an intrauterine infection, typically causes fetal tachycardia due to stress and inflammation, not bradycardia. While serious, it does not align with a sustained FHR of 100/min, making it incorrect for this fetal condition.
Choice C reason: Maternal hypoglycemia may cause fetal distress, but it is more likely to result in tachycardia or variable decelerations, not sustained bradycardia. Its impact on FHR is less direct, making it an incorrect primary cause for this finding.
Choice D reason: Fetal anemia reduces oxygen-carrying capacity, leading to sustained bradycardia (FHR <110/min) due to hypoxia. This condition, often from hemolytic disease or bleeding, directly causes low FHR, requiring urgent evaluation, making it the correct cause.