Author Question: The client has been abusing alcohol for several years and tells the nurse, I used to drink a pint of ... (Read 82 times)

berenicecastro · **on:** Jul 23, 2018

The client has been abusing alcohol for several years and tells the nurse, I used to drink a pint of whiskey every day. Now I get sick and pass out after just two drinks. What does the nurse correctly recognize about this client?

1. The client has brain damage from the alcohol and cannot remember how much he consumes.
2. The client is in denial and most likely is misrepresenting the amount of alcohol he consumes.
3. The client could have liver damage, resulting in an inability to metabolize large amounts of alcohol.
4. The client's symptoms are related to hyperglycemia; he might have pancreatic damage.

Question 2

A client with an extensive history of alcoholism is having coronary bypass surgery. While administering anesthesia, the certified nurse anesthetist notes that the client requires greater than usual amounts of the drug.

The nurse correctly evaluates this response as which phenomenon?
1. The client has developed a resistance to the anesthesia, so it will not work very well.
2. The client has developed a paradoxical reaction to the anesthesia and will require a different drug.
3. The nurse anesthetist most likely did not calculate the correct amount of anesthesia for this client.
4. The client had developed cross-tolerance to the anesthesia and will require greater amounts.

ErinKing · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 3
Rationale 1: While clients with alcoholism frequently have brain damage, this client is describing the results of liver damage.
Rationale 2: While clients with alcoholism are frequently in denial and tend to downplay the amount of alcohol they consume, this client is describing the results of liver damage.
Rationale 3: Alcoholism is a common cause of cirrhosis, a debilitatingand often fatalfailure of the liver to perform its vital functions, such as metabolism of alcohol.
Rationale 4: While clients with alcoholism frequently have pancreatic damage, this client is describing the results of liver damage.
Global Rationale: Alcoholism is a common cause of cirrhosis, a debilitatingand often fatalfailure of the liver to perform its vital functions, such as metabolism of alcohol. While clients with alcoholism frequently have brain damage, this client is describing the results of liver damage. While clients with alcoholism are frequently in denial and tend to downplay the amount of alcohol they consume, this client is describing the results of liver damage. While clients with alcoholism frequently have pancreatic damage, this client is describing the results of liver damage.

Answer to Question 2

Correct Answer: 4
Rationale 1: Resistance refers to the immune system; infections and should not be used interchangeably with tolerance.
Rationale 2: Paradoxical refers to the opposite response; in this case, the client would have become very excitable. There is no evidence of this.
Rationale 3: There is no evidence to support that the nurse anesthetist incorrectly calculated the anesthesia dose.
Rationale 4: With chronic alcohol use, the liver adapts and metabolizes alcohol at a faster rate. More of the substance is required to achieve the same effect. This is a phenomenon known as cross-tolerance. This client has a tolerance to alcohol, so he will require additional anesthesia for surgery, since both drugs are CNS depressants.
Global Rationale: With chronic alcohol use, the liver adapts and metabolizes alcohol at a faster rate. More of the substance is required to achieve the same effect. This is a phenomenon known as cross-tolerance. This client has a tolerance to alcohol, so he will require additional anesthesia for surgery, since both drugs are CNS depressants. Resistance refers to the immune system; infections and should not be used interchangeably with tolerance. Paradoxical refers to the opposite response; in this case, the client would have become very excitable. There is no evidence of this. There is no evidence to support that the nurse anesthetist incorrectly calculated the anesthesia dose.