A nurse is caring for a client who has a recent diagnosis of alcohol use disorder. Which of the following statements made by the client indicates acceptance of the diagnosis?

A. "Why are you having difficulty coping?": This question may sound accusatory and could make the client feel defensive. It is more effective to explore their feelings and concerns in a non-judgmental way.

B. "You should find a therapist who can help you.": While therapy can be helpful, this statement is directive and does not invite the client to express their feelings. It also may come across as dismissive of the client's current struggles.

C. "Everything will be okay if you give it some time.": This statement minimizes the client's feelings and may invalidate their experience. It's important to acknowledge their emotions and work with them to explore coping strategies rather than offering empty reassurances.

D. "Tell me about your support system.": This is the most appropriate response, it encourages the client to reflect on the resources and people they can rely on and provides an opportunity for the nurse to assess the client's support network and coping mechanisms.

Rationale for correct choices:

• Administer metoclopramide 10 mg IM: The client is experiencing nausea and vomiting, and metoclopramide is an antiemetic that can help alleviate these symptoms. Managing nausea is crucial for preventing further dehydration and discomfort, especially as the client is refusing to eat or drink anything and has been vomiting most of the night.
• Administer diazepam 10 mg PO: Diazepam is a benzodiazepine used to manage alcohol withdrawal symptoms, such as anxiety and the risk of seizures. It should be administered to prevent severe withdrawal symptoms and ensure the client’s safety, once nausea is managed.

Rationale for incorrect choices:

• Offer ice chips and fluids: While ice chips may help with hydration, the priority is to address the nausea and alcohol withdrawal symptoms first. Administering metoclopramide is the first step to manage nausea, making fluid intake more tolerable.
• Do a CBC and basic metabolic profile: These tests are important for monitoring the client’s condition but are not as urgent as managing nausea and alcohol withdrawal symptoms. These tests should be completed once the acute symptoms are addressed.
• Perform alcohol use disorders identification test (AUDIT): The AUDIT is useful for assessing the severity of alcohol use disorder, but it is not an immediate priority. Managing the client's physical symptoms takes precedence before conducting assessments.
• Begin substance use group therapy: Group therapy is an essential part of treatment but should not be initiated before addressing the client’s immediate physical needs, particularly nausea and alcohol withdrawal symptoms.