Answer to Question 1
A
This patient shows signs of alcohol use disorder, according to the AUDIT Screening Instrument, and has a score of at least 21 points from the information included in this history. A score of 8 or higher for men up to age 60 and a score of 4 or higher for others are positive screening results. The patient recently has consumed alcohol, as evidenced by the detectable smell, although the amount consumed and the time since the last drink cannot be determined. Because this patient is an active alcoholic, the risk of withdrawal symptoms is high; therefore, the patient needs medi-cation to facilitate withdrawal. Benzodiazepines are the safest, most effective medications for this purpose, and those with longer half-lives, including chlordiazepoxide, are preferred. Cloni-dine is useful as an adjunct to help reduce autonomic symptoms associated with withdrawal. Disulfiram is used to maintain abstinence; its use along with alcohol can produce dangerous symptoms. Naltrexone is used to maintain abstinence by reducing cravings; it does not facilitate withdrawal.
Answer to Question 2
C
Anticholinergic drugs, such as atropine Sal-Tropine, may be given to reduce the risk of brady-cardia during surgery. Atropine can alter bronchial secretions, but the effect would be to reduce them, not increase them. It is not used to reduce anxiety. It does not cause muscle paralysis.
Sharing patient information with colleagues is an important nursing role
The liver in this photograph was from a deceased patient with an advanced state of cirrhosis.
Medicinal leeches on a patient’s neck. Today leeches are sometimes used in microsurgery to prevent b
A physician uses a portable electronic tablet to enter patient data while in the examination room.
The physician uses auscultation to listen to a patient’s heart.
Algorithm for assessing a patient at risk for self-directed violence.