The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles, and the nurse suspects pulmonary edema. The nurse immediately asks another nurse to contact the healthcare provider and prepares to implement which priority interventions? (Select all that apply.)

Choice A reason : Avoidant personality disorder is characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Individuals with this disorder may avoid work activities or decline job offers due to fears of criticism or rejection. However, they do not typically exhibit a need for constant reassurance or an inability to make decisions, which are more indicative of dependent personality disorder⁵⁶.

Choice B reason : Borderline personality disorder involves a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity. While individuals with borderline personality disorder may exhibit dependency traits, they are more likely to engage in frantic efforts to avoid real or imagined abandonment and may have a pattern of unstable and intense interpersonal relationships⁷⁸.

Choice C reason : Dependent personality disorder is characterized by a pervasive and excessive need to be taken care of, leading to submissive and clinging behavior and fears of separation. Individuals with this disorder often require excessive advice and reassurance from others to make everyday decisions and may feel helpless when alone due to exaggerated fears of being unable to care for themselves. The need for constant reassurance and inability to make decisions align with the symptoms of dependent personality disorder¹²³⁴.

Choice D reason : Schizoid personality disorder is characterized by a lack of interest in social relationships, a tendency toward a solitary lifestyle, secretiveness, emotional coldness, detachment, and apathy. Individuals with schizoid personality disorder prefer to be alone and do not seek out social interactions or relationships. They do not typically display the need for reassurance or the inability to make decisions, as seen in dependent personality disorder¹²¹³¹⁴.

Choice A reason : While helping the client identify positive personality traits can be beneficial for self-esteem and long-term recovery, it is not the immediate priority during the acute withdrawal phase. The focus during this time should be on managing withdrawal symptoms and ensuring the client's safety¹.

Choice B reason : Providing for adequate hydration and rest is the priority intervention for a client in alcohol withdrawal. Withdrawal can lead to significant fluid loss due to vomiting and sweating, and rest is essential for the body to recover from the physiological stress of detoxification. Ensuring the client is well-hydrated and rested can prevent complications and aid in the recovery process¹².

Choice C reason : Educating the client about the consequences of alcohol misuse is an important part of treatment but is not the immediate priority during withdrawal. Education is more effective when the client is stable and can participate actively in learning and discussion¹.

Choice D reason : Confronting the use of denial and other defense mechanisms may be part of the therapeutic process but is not the immediate priority during the acute phase of withdrawal. The nurse's immediate concern should be the physical stabilization of the client¹.