A nurse is working with a client who is the caregiver of a family member who has a serious mental illness. Which of the following statements by the client indicates acceptance of the role change?

A. "If I were you, I would go to a few therapy sessions to give them a try": This statement is not appropriate because it places the nurse's personal perspective onto the client, potentially pressuring them. It does not respect the client's autonomy in making their own decisions.

B. "One of my friends went to group therapy and they improved significantly": Sharing personal experiences can make the client feel uncomfortable and may not be relevant to their own situation. It can also create a sense of comparison, which is not helpful.

C. "You have the right to refuse to attend group therapy": This statement is respectful of the client's autonomy and acknowledges their right to make decisions about their care. It empowers the client and maintains their dignity while respecting their refusal.

D. "You should go to group therapy if you want to get better": This statement may feel coercive, as it implies that the client "should" attend therapy to improve. It might lead the client to feel guilty or pressured rather than supported in their choice.

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.