A patient presents to the emergency department with a blood ...

[maychende]

A patient presents to the emergency department with a blood alcohol concentration (BAC) of 0.18. After reviewing the medication orders, which drug should the nurse administer first?
 
  a. Thiamine (vitamin B1) 100 mg daily
  b. Lorazepam (Ativan) 1 mg as needed
  c. Folic acid (Vitamin B9) 0.4 mg daily
  d. Dextrose 5 in 0.45 saline at 125 mL/hr

Question 2

Which information is most important for the nurse to report to the health care provider about a patient who has been using varenicline (Chantix)?
 
  a. The patient continues to smoke a few cigarettes every day.
  b. The patient complains of headaches that occur almost daily.
  c. The patient complains of new-onset sadness and depression.
  d. The patient says, I have decided that I am not ready to quit.

[Harbringer]

Answer to Question 1

ANS: A
Thiamine is given to all patients with alcohol intoxication to prevent Wernicke's encephalopathy. Because Wernicke's encephalopathy can be precipitated by the administration of glucose solutions, the thiamine should be given before (or concurrently with) the 5 dextrose solution. Lorazepam would not be appropriate while the patient still has an elevated BAC. Folic acid may also be administered, but is not as important as thiamine.

Answer to Question 2

ANS: C
Adverse effects of varenicline include depression and attempted suicide. The patient's symptoms require immediate assessment and discontinuation of the drug. The other information will also be reported, but it does not indicate any life-threatening problems associated with the medication.

[maychende]

Thank you

[Harbringer]

No problemo