A nurse is caring for a client who has alcohol use disorder.
Which of the following findings should indicate to the nurse that the client is experiencing the initial stage of acute withdrawal?

Choice A rationale

Depression is a mood disorder characterized by persistent sadness, loss of interest, and feelings of hopelessness. While it can co-occur with alcohol use disorder, it is not typically the initial manifestation of acute alcohol withdrawal. Acute withdrawal primarily involves physiological and neurological symptoms resulting from the abrupt cessation of alcohol consumption.

Choice B rationale

Delusions are fixed false beliefs that are not based in reality. These are more characteristic of severe alcohol withdrawal, such as delirium tremens, or other psychotic disorders, rather than the initial stage of acute withdrawal. The initial stage is typically marked by milder symptoms related to central nervous system hyperactivity.

Choice C rationale

Tremors, particularly hand tremors, are a common and characteristic early sign of acute alcohol withdrawal. Alcohol has a depressant effect on the central nervous system. When alcohol consumption is stopped, the central nervous system rebounds, leading to increased neuronal excitability. This hyperactivity manifests as tremors, along with other symptoms like anxiety and increased heart rate.

Choice D rationale

Bradycardia, a heart rate below 60 beats per minute, is not a typical finding in the initial stage of acute alcohol withdrawal. Instead, the sympathetic nervous system activation that occurs during withdrawal usually leads to tachycardia (an elevated heart rate) and hypertension as the body attempts to compensate for the absence of alcohol's depressant effects.