Exam (elaborations) NURSING 432(NURSING 432 FA Jonathan Herman/NURSING 432 FA Jonathan Herman | Interview the Patient | Review - Answers and Rationale. Coppin State University

NURSING 432 FA Jonathan Herman | Interview the Patient | Review - Answers and Rationale. Coppin State UniversityNURSING 432 FA Jonathan Herman | Interview the Patient | Review - Answers and Rationale. Coppin State University.Your responses and feedback are displayed below. For more information regarding feedback, click "Help". When you are finished reviewing, click "Continue" to proceed to next section. 1. How long have you had a problem with alcohol? Rationale Relevancy Your Answer Because the criteria for withdrawal reflects cessation of (or reduction of) heavy and prolonged substance abuse, it is important to determine the length of use. Relevant Relevant Client’s Mother: Jonathan’s drinking has been out of control for at least 7 years. He is a binge drinker. Sometimes he is able to control his drinking and then he has periods when he drinks heavily for several weeks at a time. Recently, he lost 25 pounds, broke up with his girlfriend, and was charged with DUI but kept drinking and then I have to look after him. Client: I have tried to quit before, but just can’t seem to stop. When my life gets out of control and is so stressful, I need it just to get through the day. 2. Do you only drink alcohol, or have you also used other substances? Rationale Relevancy Your Answer It is important to determine if the client has used or is using other substances. Relevant Relevant Client’s Mother: Jonathan told me he only drank alcohol. He said he had never touched any other type of drug. Client: I have never used any other drugs or substances. 3. Have you ever tried to cut down on your drinking? Rationale Relevanc y Your Answer It has already been established that Jonathan began withdrawal symptoms when he abruptly quit drinking. It is not necessary to repeat gathering information on this portion of the history. The nurse should concentrate on the withdrawal symptoms for which Jonathan is admitted. Irrelevant Irrelevant Client’s Mother: Several times, and he has been for court mandated treatment in the past. He comes home and starts drinking again. I have had to call in sick for him when he is still too drunk to go to work. 4. Do you feel that you have needed more alcohol in recent months in order to become intoxicated? Rationale Relevancy Your Answer It has already been established that Jonathan has substance dependence. It is not necessary to repeat gathering information on this portion of the history. The nurse should concentrate on the withdrawal symptoms for which Jonathan is admitted. Irrelevant Irrelevant Client’s Mother: Yes, he seemed to continue to drink more and more. Sometimes I find bottles of alcohol hidden in the basement, so I hide them where he cannot find them. At other times he has gone to a motel and spent several days there drinking. I’ve had to drive around to find him and bring him home to sober him up. 5. Have you lost jobs or employment opportunities as a result of your drinking? Rationale Relevanc y Your Answer Substance abuse is characterized by failure to fulfill a major role obligation (e.g., his role as a carpenter). Because Jonathan has already been diagnosed with a substance abuse problem, it is not necessary to repeat gathering information on this portion of the history. The nurse should concentrate on the withdrawal symptoms for which Jonathan is admitted. Irrelevant Irrelevan t Client’s Mother: Yes, he has lost some very good jobs. Employers say he is a good worker but he has been fired for drinking on the job. He lost his latest job a couple of weeks ago when he was caught drinking at work. Then his girlfriend broke up with him. 6. Did your symptoms begin when you quit drinking? Rationale Relevancy Your Answer Signs and symptoms that manifest once the client significantly reduces or ceases taking the substance characterize substance withdrawal. Relevant Relevant Client’s Mother: Yes, before that he didn’t have any of these symptoms. This is how he always gets when he quits drinking. Client: Yes, I have gone into withdrawal before, but it seems to be worse this time. 7. Have you been sweating more or felt like your heart is racing? Rationale Relevanc y Your Answer Withdrawal symptoms from alcohol include two or more of the following: autonomic hyperactivity (sweating, pulse rate greater than 100 beats per minute), increased hand tremor, insomnia, psychomotor agitation, anxiety, nausea or vomiting, and rarely, grand mal seizures or transient visual, tactile, or auditory hallucinations or illusions. Relevant Relevant Client’s Mother: Yes, over the last 2 days he’s said he feels like his heart is “beating out of his body.” Client: My mom just stresses me out, she just won’t stop. She is always at me. I need to drink just to try to deal with her. 8. Did you take a drink over the past 12 hours before being admitted and, if so, did your symptoms get any better? Rationale Relevancy Your Answer If a client is truly in withdrawal, administration of the offending substance will relieve symptoms. Relevant Relevant Client’s Mother: Yes, I gave him several drinks last night to try to control the symptoms and he got a little better. I have done that before to help him get off the alcohol. This morning I put him in the car and brought him here. 9. When did you quit drinking?