Anxiety Disorders and Stress Q 49
The care for the client places priority on which of the following:
A. Monitoring his vital signs every hour.
B. Providing a quiet, dim room.
C. Encouraging adequate fluids and nutritious foods.
D. Administering Librium as ordered.
Correct Answer: A. Monitoring his vital signs every hour
Pulse and blood pressure are usually elevated during withdrawal; Elevation may indicate impending delirium tremens. Patients with severe withdrawal symptoms may require escalating doses and intensive care level monitoring. Alcohol withdrawal can range from very mild symptoms to the severe form, which is named delirium tremens. The hallmark is autonomic dysfunction resulting from the excitation of the central nervous system.
Option B: The client needs a quiet, well-lighted, consistent, and secure environment. Excessive stimulation can aggravate anxiety and cause illusions and hallucinations. Patients should be kept calm in a controlled environment to try to reduce the risks of progression from mild symptoms to hallucinations. With mild to moderate symptoms, patients should receive supportive therapy in the form of intravenous rehydration, correction of electrolyte abnormalities, and have comorbid conditions as listed above ruled out.
Option C: Adequate nutrition with supplements of Vit. B should be ensured. Alcoholics tend to have nutritional deficiencies and thus should be provided with folic and thiamine supplements. Some patients may benefit from magnesium supplements.
Option D: Sedatives are used to relieve anxiety. The hallmark of management for severe symptoms is the administration of long-acting benzodiazepines. The most commonly used benzodiazepines are intravenous diazepam (Valium) or intravenous lorazepam (Ativan) for management.