Which of the following statements by the nurse requires intervention by the charge nurse when a client is sharing concerns about their marriage?

Choice A Reason:

An overdose of disulfiram can cause symptoms such as nausea and vomiting, but it is less likely to be the cause in this scenario. Overdoses typically present with more severe symptoms, including seizures and coma in rare cases¹. The client's symptoms are more consistent with a disulfiram-alcohol reaction.

Choice B Reason:

An allergic response to disulfiram can cause symptoms such as rash, itching, and swelling, but severe nausea and vomiting are not typical allergic reactions². Allergic reactions would also likely present with other symptoms such as difficulty breathing or hives, which are not mentioned in this case.

Choice C Reason:

While nausea and vomiting can be common side effects of disulfiram, the severity described by the client suggests a more significant reaction. Common side effects are usually milder and do not typically cause the client to stop the medication abruptly.

Choice D Reason:

The most likely cause of the client's severe nausea and vomiting is the consumption of alcohol while taking disulfiram. Disulfiram works by inhibiting the enzyme acetaldehyde dehydrogenase, leading to an accumulation of acetaldehyde when alcohol is consumed. This results in unpleasant effects such as severe nausea, vomiting, headache, and flushing. The client's symptoms align with this reaction, making it the most probable cause.

Choice A Reason:
"I understand that you feel like you don't need it; however, the provider thinks it will help." This response acknowledges the client's feelings but immediately contradicts them by emphasizing the provider's opinion. This can make the client feel invalidated and less likely to engage in therapy. A therapeutic response should validate the client's feelings and encourage open communication without imposing the provider's perspective.

Choice B Reason:
"You don't feel like group therapy is for you. Tell me more about what you know about group therapy." This response is therapeutic because it validates the client's feelings and invites them to share their thoughts and knowledge about group therapy. It opens up a dialogue, allowing the nurse to understand the client's perspective better and address any misconceptions or fears they may have. This approach fosters a collaborative and empathetic relationship, which is crucial in therapeutic settings.

Choice C Reason:
"I am not saying that you need therapy, but I am sure it will help you." This response attempts to reassure the client but can come across as dismissive of their feelings. It implies that the nurse knows better than the client, which can create a power imbalance and hinder the therapeutic relationship. Effective therapeutic communication should empower the client and respect their autonomy.

Choice D Reason:
"You don't have to be afraid to go. Our therapists are very understanding." While this response aims to reassure the client, it assumes that fear is the primary reason for their reluctance. It does not validate the client's expressed feelings or invite further discussion. Therapeutic communication should be based on active listening and addressing the client's specific concerns.