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A nurse is reviewing provider prescriptions for a client who is experiencing alcohol withdrawal.

Exhibits

Complete the following sentence by using the lists of options.

The nurse should first

followed by.
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"B"}

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.


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Related Questions

Correct Answer is A

Explanation

A. The nurse has witnessed the client's signature on the form: The nurse’s signature indicates they witnessed the client voluntarily sign the consent form. The nurse does not provide information but confirms that the client signed without coercion.
B. The nurse has assessed the client's knowledge of alternative treatments: Assessing the client’s knowledge of alternatives is typically the provider’s responsibility, not the nurse’s. The nurse’s role is to ensure that the client signed the form voluntarily.
C. The nurse has discussed the risks of ECT with the client: Discussing risks is the provider’s responsibility. The nurse’s role is to observe that the client is signing the form after receiving adequate explanation of risks from the provider.
D. The nurse has provided information about the benefits of ECT: Providing information on benefits is the provider’s role. The nurse can clarify any doubts, but the provider must explain the benefits of the treatment before consent is given.

Correct Answer is A

Explanation

A. Schedule the client for a morning group fitness class at the facility: Regular morning exercise promotes healthy sleep patterns by helping regulate the body's circadian rhythm. Engaging in physical activity early in the day can reduce restlessness at night.

B. Limit the client to no more than four caffeinated beverages a day: While caffeine should be limited, the most effective approach is to avoid caffeine entirely in the afternoon and evening to prevent sleep disruption, rather than just limiting it to four beverages a day.

C. Walk around the hallway with the client an hour before bedtime: Although light physical activity can promote sleep, intense exercise or walking too close to bedtime can sometimes increase alertness and make it harder for the client to fall asleep.

D. Allow the client several hours in the afternoon to take a nap: Long naps, especially in the afternoon, can disrupt the client's sleep cycle and make it more difficult for them to fall asleep at night. Limiting naps during the day is typically more helpful.

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