An adult client underwent a short plasma corticotropin (ACTH) stimulation test this morning. What subsequent assessment finding would rule out a diagnosis of adrenal insufficiency?

Disulfiram is a medication used to treat alcohol use disorder (AUD). It works by inhibiting the enzyme acetaldehyde dehydrogenase, which is responsible for breaking down acetaldehyde, a toxic metabolite of alcohol. When alcohol is consumed while taking disulfiram, the accumulation of acetaldehyde in the body leads to unpleasant symptoms such as flushing, sweating, nausea, and vomiting. This creates an aversive reaction to alcohol consumption, which can help the client refrain from drinking.

The aversive effects of disulfiram can last for several hours to several days after alcohol consumption, depending on the dose of disulfiram and the amount of alcohol consumed. Therefore, it is important for clients taking disulfiram to avoid all sources of alcohol, including alcoholic beverages, mouthwash, and other products containing alcohol.

It is important to note that disulfiram is not a cure for AUD, and it works best when used as part of a comprehensive treatment plan that includes counseling and support. Disulfiram should only be used under the close supervision of a healthcare provider, as it can have serious side effects if used improperly.

Metformin is an oral medication used to lower blood sugar levels in clients with type 2 diabetes. It works by decreasing the production and absorption of glucose in the liver and intestines, respectively. However, metformin is contraindicated in clients with severe infections, as the drug can increase the risk of developing lactic acidosis, a rare but serious complication characterized by the buildup of lactic acid in the bloodstream.

During a severe infection, the body may experience a state of inflammation and stress, which can cause metabolic changes that increase the risk of developing lactic acidosis. Therefore, metformin should be temporarily discontinued in clients with severe infections and resumed only after the infection has been successfully treated and resolved.

In the meantime, the client's diabetic regimen may need to be adjusted to maintain appropriate blood sugar levels. This may include the use of alternative medications such as insulin, which can be used to control blood sugar levels during times of illness or infection. The healthcare provider will determine the appropriate management plan based on the individual client's needs and medical history.