The nurse is caring for a client who is experiencing marked confusion, unsteady gait and diplopia after being admitted to the hospital for alcohol withdrawal. Which of the following nursing interventions is the priority for the nurse to implement?
1. Encourage adequate nutrition and fluids.
2. Administer prescribed thiamine.
3. Provide safety measures.
4. Administer prescribed benzodiazepine.
Please don't consult any books, and answer it right away as you would do on the actual exam. I'm curious if it's a hard question or if I have poor critical thinking skills (well, they are poor, but I want to know how poor). :)
remember what you agreed to upon sign up: you will not use this bb to post free advertising or solicitations, any material which is knowingly false and/or defamatory, inaccurate, abusive, vulgar, hateful, harassing, obscene, profane, sexually oriented, threatening, invasive of a person's privacy, or otherwise violative of any law. you agree not to post any copyrighted material unless the copyright is owned by you or by this bb.
----
immediately #2 jumped out at me as correct answer because scenario gave these clues:
a. pt signs + symptoms listed
b. medical diagnosis given
c. rn needs to be able to coorelate patient symptoms with medical diagnosis given
d. rn needs to promptly intervene with medication management to prevent worsening symptoms/condition
if pt does not receive thiamine, then dioplopia won't reverse and encephalopathy will ensue. safety efforts have minimal effect on disease process ---that's what this question is all about.
what answer will most effect disease process = thiamine, vitamin b1
dosage given is usually higher than standard iv multivitimin vial dose.
NRSKarenRN, BSN, RN
10 Articles; 19,178 Posts
posting verbatim nclex questions from copyrighted sources is against our tos that one agrees to at sign-up:
terms of service - all users please read and follow
https://allnurses.com/forums/f8/allnurses-com-terms-service-welcome-all-members-please-read-31788.html
remember what you agreed to upon sign up: you will not use this bb to post free advertising or solicitations, any material which is knowingly false and/or defamatory, inaccurate, abusive, vulgar, hateful, harassing, obscene, profane, sexually oriented, threatening, invasive of a person's privacy, or otherwise violative of any law. you agree not to post any copyrighted material unless the copyright is owned by you or by this bb.
----
immediately #2 jumped out at me as correct answer because scenario gave these clues:
a. pt signs + symptoms listed
b. medical diagnosis given
c. rn needs to be able to coorelate patient symptoms with medical diagnosis given
d. rn needs to promptly intervene with medication management to prevent worsening symptoms/condition
if pt does not receive thiamine, then dioplopia won't reverse and encephalopathy will ensue. safety efforts have minimal effect on disease process ---that's what this question is all about.
what answer will most effect disease process = thiamine, vitamin b1
dosage given is usually higher than standard iv multivitimin vial dose.
alcohol-related neurologic disease
korsakoff's syndrome