A nurse on a mental health unit is preparing an in-service about ethical concepts when providing client care. Which of the following definitions should the nurse include when discussing advocacy?

Rationale for correct choices:

• Fingernail assessment: Broken fingernails can be a sign of a struggle, as the client may have tried to defend themselves during the assault. Such injuries are commonly seen in cases of sexual assault, where victims may attempt to resist or protect themselves.
• Diagnostic results: The positive urine drug screen for GHB is key as it is often used as a "date rape drug" due to its ability to cause sedation, memory loss, and impaired judgment. Its presence supports the possibility of the client being drugged as part of a sexual assault.

Rationale for incorrect choices:

• Blood pressure: Blood pressure readings are typically not indicative of sexual assault. While anxiety or trauma can affect blood pressure, this measurement alone does not provide information directly related to sexual assault. Her BP is also within normal range.
• Abdominal examination: Mild tenderness in the abdomen could be incidental or related to other causes but is not directly linked to the typical findings in a sexual assault case. Abdominal examination would generally not be the primary assessment for identifying sexual assault unless there was significant trauma or injury to the abdomen.
• Temperature: A normal temperature of 37°C (98.6°F) does not indicate anything specific to sexual assault. While fever may occur in cases of infection, it is not a defining characteristic of sexual assault and doesn't help in confirming the occurrence.

Rationale:

• Schedule electroconvulsive therapy (ECT): ECT is a treatment for severe depression, bipolar disorder, or catatonia that has not responded to other treatments. It is not indicated for the acute management of alcohol withdrawal syndrome or alcohol use disorder.
• Diazepam 10 mg PO three times a day: Diazepam is commonly used to manage alcohol withdrawal symptoms due to its sedative and anticonvulsant properties. It helps prevent withdrawal seizures and reduces anxiety during the withdrawal period.
• Perform Alcohol Use Disorders Identification Test (AUDIT): This assessment tool is appropriate for evaluating the severity of alcohol use disorder and understanding the client’s alcohol consumption patterns. It is essential for treatment planning and ongoing care.
• Group therapy: Group therapy is an essential component of alcohol use disorder treatment. It offers support, accountability, and shared experiences, which are vital in maintaining sobriety.
• Complete blood count and basic metabolic profile: These lab tests are necessary to monitor the client's overall health and identify potential complications related to alcohol withdrawal, such as electrolyte imbalances, anemia, or liver dysfunction.
• Nutritional consult: Clients with alcohol use disorder often have poor nutrition, and a nutritional consult is essential to address deficiencies, provide guidance, and support recovery.

• Methadone 40 mg PO daily: Methadone is used for opioid withdrawal and maintenance treatment, not for alcohol use disorder. It is contraindicated in this client’s care, as it is not indicated for alcohol withdrawal or management.
• Propranolol 40 mg PO twice a day: Propranolol may be used to manage the autonomic symptoms of alcohol withdrawal, such as elevated heart rate and blood pressure. It can help control symptoms like tremors and anxiety, making it an appropriate choice.