A nurse is caring for a client who is combative and requires wrist restraints. Which of the following actions should the nurse take?

Choice A reason: This statement is an indication of countertransference because the nurse is projecting personal feelings and experiences onto the client. By comparing the client to their parent who struggled with drinking, the nurse may unconsciously treat the client differently based on unresolved emotions or past experiences. Countertransference can interfere with the nurse's ability to provide objective and compassionate care.

Choice B reason: This statement reflects a judgment about the client's responsibility for their drinking but does not indicate countertransference. While it is important for clients to take responsibility for their actions, this statement does not involve the nurse projecting their own feelings or experiences onto the client. It is more about the nurse's perspective on the client's behavior.

Choice C reason: This statement describes an inappropriate boundary violation by the client but does not indicate countertransference on the part of the nurse. The nurse should address the boundary issue professionally, but this situation does not involve the nurse's personal feelings or experiences influencing their perception of the client.

Choice D reason: This statement is a factual observation about the client's behavior during group therapy and does not indicate countertransference. It reflects the client's willingness to share their feelings, which is a positive aspect of their therapy process. There is no evidence of the nurse's personal feelings or experiences affecting their assessment of the client.

Choice A reason: Serum creatinine levels are commonly used to assess kidney function. While kidney function is important, it does not specifically evaluate nutritional status. Chronic alcohol use can impact multiple organs, but thiamine deficiency is a more direct concern related to nutritional status in these patients.

Choice B reason: Thiamine (vitamin B1) deficiency is a well-known complication of chronic alcohol use disorder. Alcohol interferes with the absorption and utilization of thiamine, leading to deficiencies that can cause severe neurological problems, such as Wernicke's encephalopathy and Korsakoff's syndrome. Monitoring thiamine levels is crucial in assessing and managing the nutritional status of clients with chronic alcohol use disorder.

Choice C reason: Urinalysis is a basic test that can provide information about kidney function and the presence of infections, among other things. However, it is not specifically useful in evaluating the nutritional status of a client with chronic alcohol use disorder. Nutritional deficiencies would not be directly assessed through a routine urinalysis.

Choice D reason: Erythrocyte sedimentation rate (ESR) is a non-specific marker of inflammation and is used to detect inflammatory conditions. While it can provide information on inflammatory processes, it does not directly assess nutritional status. The nutritional impact of chronic alcohol use disorder is more accurately evaluated by specific nutrient levels, such as thiamine.