Substance Abuse and Abuse Q 23
The spouse of a client admitted to the mental health unit for alcohol withdrawal says to the nurse “I should get out of this bad situation.” The most helpful response by the nurse would be:
A. “I agree with you. You should get out of this situation.”
B. “What do you find difficult about this situation?”
C. “Why don’t you tell your husband about this?”
D. “This is not the best time to make that decision.”
Correct Answer: B. “What do you find difficult about this situation?”
The most helpful response is one that encourages the client to problem solve. Giving advice implies that the nurse knows what is best and can foster dependency. Develop a trusting relationship through frequent contact being honest and nonjudgmental. Project an accepting attitude about alcoholism. Provides the patient with a sense of humanness, helping to decrease paranoia and distrust. The patient will be able to detect biased or condescending attitudes of caregivers.
Option A: Determine the cause of anxiety, involving the patient in the process. Explain that alcohol withdrawal increases anxiety and uneasiness. Reassess level of anxiety on an ongoing basis. Person in an acute phase of withdrawal may be unable to identify and accept what is happening. Anxiety may be physiologically or environmentally caused. Continued alcohol toxicity will be manifested by increased anxiety and agitation as effects of the medication wear off.
Option C: The nurse should not agree with the client, nor should the nurse request that the client provide explanations. Inform the patient about what you plan to do and why. Include the patient in the planning process and provide choices when possible. Enhances sense of trust, and explanation may increase cooperation and reduce anxiety. Provides a sense of control over self in circumstances where loss of control is a significant factor. Note: Feelings of self-worth are intensified when one is treated as a worthwhile person.
Option D: Reorient frequently to person, place, time, and surrounding environment as indicated; may reduce confusion, prevent and limit misinterpretation of external stimuli. Avoid bedside discussion about the patient or topics unrelated to the patient that do not include the patient. Provide a calm environment, minimizing noise and shadows.