A client was admitted to the emergency department with slurred speech and impaired motor coordination. The blood alcohol level is over 300 mg/dL. The physician orders thiamine for the client. The nurse understands that the physician ordered thiamine to:
Prevent Wernicke's encephalopathy.
Prevent alcoholic hepatitis.
Rehydrate the client.
Prevent pancreatitis.
The Correct Answer is A
Choice A Reason
Thiamine, or vitamin B1, is essential for brain function and the metabolism of carbohydrates. In the context of high blood alcohol levels, thiamine is administered to prevent Wernicke's encephalopathy, a serious neurological disorder. This condition is often precipitated by a thiamine deficiency, which can be exacerbated by alcohol abuse. Alcohol consumption can impair thiamine absorption and utilization, leading to depleted stores. Wernicke's encephalopathy is characterized by symptoms such as confusion, ataxia, and ophthalmoplegia, and if left untreated, it can progress to Korsakoff syndrome, a chronic and debilitating condition.
Choice B Reason
While alcoholic hepatitis is a concern in individuals with excessive alcohol intake, thiamine is not specifically used to prevent this condition. Alcoholic hepatitis is inflammation of the liver due to alcohol abuse, and its prevention primarily involves abstinence from alcohol, nutritional support, and medical management of liver inflammation. Thiamine does not play a direct role in preventing liver inflammation but is crucial for overall nutritional replenishment in individuals with alcohol use disorder.
Choice C Reason
Rehydration is indeed important for clients with high blood alcohol levels; however, thiamine does not serve this purpose. Rehydration typically involves the administration of intravenous fluids to restore fluid balance and electrolytes. Thiamine is not a rehydrating agent but is given to prevent neurological complications associated with thiamine deficiency, which can be seen in individuals with chronic alcoholism.
Choice D Reason
Preventing pancreatitis is not the primary reason for administering thiamine in this scenario. Pancreatitis, an inflammation of the pancreas, can be associated with chronic alcohol abuse, but thiamine is not used as a preventative treatment for this condition. The management of pancreatitis involves addressing the underlying causes, supportive care, and sometimes hospitalization for more severe cases.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason
Hyperreflexia refers to an overactive or overresponsive reflexes, which is a neurological condition and not directly related to the behaviors described. It is typically seen in conditions affecting the central nervous system and is not characterized by the inability to wait turns or interrupting conversations.
Choice B Reason
Defiance implies a conscious choice to resist authority or rules, which may not necessarily be the case here. While children with behavioral issues may exhibit defiant behaviors, the symptoms described are more indicative of a lack of impulse control rather than a deliberate choice to defy.
Choice C Reason
Inattention is a component of several behavioral and cognitive disorders, including ADHD. However, the behaviors described—blurting out answers, inability to wait for turns, and interrupting others—are more specifically associated with impulsivity rather than inattention alone.
Choice D Reason
Impulsivity is the tendency to act on a whim, displaying behavior characterized by little or no forethought, reflection, or consideration of the consequences. The behaviors described—such as blurting out answers and interrupting others—are classic signs of impulsivity, which is often seen in conditions like ADHD.
Correct Answer is A
Explanation
Choice A Reason
Petechiae on the chest are a classic sign of fat emboli syndrome (FES). FES is a rare but serious complication that can occur after a long bone fracture, such as a femur fracture. The petechiae result from small fat droplets that travel to the skin's capillaries and cause pinpoint hemorrhages. This symptom is part of the classic triad for FES, which includes respiratory distress, neurological symptoms, and a petechial rash.
Choice B Reason
While an edematous calf may be a concern for deep vein thrombosis or other complications following a fracture, it is not a specific indicator of FES. Edema in the calf could be due to various reasons, including local trauma from the fracture itself or immobilization.
Choice C Reason
An elevated temperature can be associated with many post-injury complications, including infection or inflammatory response. However, it is not specific to FES. While patients with FES may present with fever, it is not one of the primary diagnostic criteria.
Choice D Reason
Paresthesia distal to the fracture could indicate nerve damage or compartment syndrome, which are important to assess in a patient with a femur fracture. However, paresthesia is not a specific sign of FES. The neurological symptoms associated with FES are more generalized and often include confusion or altered mental status.
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