A client has been admitted for the third time for alcoholism. She ...

[tiara099]

A client has been admitted for the third time for alcoholism. She relapsed immediately upon dis-charge previously, and she minimizes problems with alcohol. The priority outcome that can be identified would be that the client will:
 
  1. Remain compliant with the alcohol detoxification protocol
  2. Verbalize powerlessness over alcohol
  3. Remain abstinent during hospitalization
  4. Develop more effective coping skills

Question 2

A client has been admitted in withdrawal delirium. He is dehydrated and has a bruised, swollen tongue.
 
  He is experiencing illusions and auditory hallucinations and is confused. In developing a care plan for this client, what measures should the nurse include to ensure physiologic stability?
  1. Applying ice to the tongue
  2. Withholding oral fluids
  3. Keeping the room dark
  4. Monitoring vital signs

[olderstudent]

Answer to Question 1

ANS: 2
The client has been compliant with detoxification, so option 1 is incorrect. She has also remained abstinent during previous hospitalizations, so option 3 is incorrect. She needs to develop more skills (option 4), but it is necessary for her to first verbalize the powerlessness and not minimize the problems, so option 2 is correct.

Answer to Question 2

ANS: 4
To provide safe care, the nurse must monitor the vital signs to assess for the physiologic life-threatening symptoms of withdrawal. The person can be given food and drink (options 1 and 2), but these are not foremost in the plan. A dark room could be problematic for someone with hallucinations so option 3 is incorrect.

[tiara099]

Excellent

[billybob123]

Gracias!