A nurse is caring for a client who is at risk for alcohol withdrawal delirium.
Which of the following medications should the nurse expect the provider to prescribe?

Choice A rationale: While oral fluid intake is important for hydration and general health, it is not an immediate priority unless there is evidence of dehydration, which is not present here. The client’s main issues are urinary symptoms and infection.

Choice B rationale: Urinalysis results showing cloudy appearance, foul odor, and elevated pH indicate a urinary tract infection (UTI), which requires immediate follow-up due to the risk of sepsis and worsening infection if untreated. Normal urine should be clear, aromatic, and have a pH of 4.6–8.0.

Choice C rationale: The client’s report of burning sensation upon urination is a classic symptom of a UTI. Dysuria, urgency, and frequency are concerning signs of infection that require prompt medical attention to prevent complications such as pyelonephritis or bacteremia.

Choice D rationale: While the amber yellow color of urine is within normal range, the associated symptoms and laboratory findings are more concerning. The color alone does not indicate an immediate issue compared to the urinalysis and reported urinary discomfort.

Choice A rationale

Diazepam is a benzodiazepine used to manage anxiety, seizures, and muscle spasms. It is not effective in treating malignant hyperthermia, a condition characterized by rapid onset of hypermetabolism and muscle rigidity triggered by certain anesthetics.

Choice B rationale

Dantrolene is the drug of choice for malignant hyperthermia. It acts by inhibiting calcium release from the sarcoplasmic reticulum in skeletal muscle, thereby reducing muscle rigidity and metabolic activity. Administer 2.5 mg/kg IV bolus initially.

Choice C rationale

Cyclobenzaprine is a muscle relaxant used to relieve muscle spasms associated with acute musculoskeletal conditions. It does not have the specific mechanism required to counteract the effects of malignant hyperthermia.

Choice D rationale

Metaxalone is a muscle relaxant used to treat discomfort associated with acute skeletal muscle conditions. It is not indicated for the treatment of malignant hyperthermia and does not address the underlying pathophysiology of the condition.