NCLEX-RNPsychosocial IntegrityHard
A client with a history of alcohol use disorder is admitted with pancreatitis. The nurse notes the client is agitated, diaphoretic, and reports seeing 'bugs crawling on the walls.' The client's last drink was 48 hours ago. Which medication should the nurse anticipate administering first?
- AThiamine
- BLorazepam
- CHaloperidol
- DPropranolol
Show answer & explanationAnswer & explanation
Correct answer: B. Lorazepam
The client's symptoms (agitation, diaphoresis, visual hallucinations) 48 hours after the last drink are classic signs of alcohol withdrawal delirium (delirium tremens). Benzodiazepines like lorazepam are the first-line treatment for alcohol withdrawal to prevent seizures, stabilize vital signs, and reduce symptoms.
Why the other options are wrong
- A. Thiamine is crucial to prevent Wernicke-Korsakoff syndrome but is not the immediate priority for acute withdrawal symptoms and seizure prevention.
- C. Haloperidol is an antipsychotic that may be used for severe hallucinations but is not the first-line treatment for alcohol withdrawal itself and can lower the seizure threshold.
- D. Propranolol is a beta-blocker that can help with some withdrawal symptoms like tremor and tachycardia but does not address the primary risk of seizures or delirium.
Alcohol Withdrawal Delirium Management
Alcohol Withdrawal Delirium (DTs) is a severe form of alcohol withdrawal characterized by hallucinations, disorientation, and autonomic instability. Benzodiazepines are the first-line treatment to manage symptoms and prevent complications.
- Occurs 48-96 hours after last drink.
- Symptoms: hallucinations, tremors, agitation, seizures.
- Benzodiazepines are primary treatment.
Memory trick: Benzos Block Bad Withdrawal.