A nurse in a pediatric office is assisting in the care of a child.

Exhibits

A nurse is contributing to the plan of care for a child. Which of the following interventions should the nurse recommend? Select the 4 interventions the nurse should recommend for the child's plan of care.

Rationale:

A. "My anxiety has been getting a little easier to deal with every day." Naltrexone is not primarily used to treat anxiety. While improvement in anxiety may occur secondarily as alcohol use decreases, this statement does not directly reflect the intended therapeutic effect of naltrexone in substance use treatment.

B. "I have not had any cravings to drink since my visit last week." Naltrexone works by blocking opioid receptors involved in the brain’s reward system, reducing cravings and the pleasurable effects of alcohol. Decreased alcohol craving is a direct and expected response to naltrexone therapy in clients with alcohol use disorder.

C. "When I had one drink last week. I had extreme nausea and vomited several times."
This describes the effect of disulfiram, not naltrexone. Disulfiram causes an aversive reaction to alcohol, while naltrexone does not produce sickness when alcohol is consumed; it simply reduces the reward response.

D. “Since I quit drinking. I have not had any hallucinations." Hallucinations are associated with alcohol withdrawal, not the effect of naltrexone. Naltrexone does not prevent withdrawal symptoms or hallucinations; it is used after detox to help maintain abstinence and reduce relapse.

Rationale:

A. Plan time to complete the task: While the nurse may need to complete the task if it remains undone, doing so without first addressing the AP’s refusal overlooks a potential communication or training issue and does not resolve the underlying problem.

B. Assign the task to another AP: Reassigning the task without understanding the reason for refusal may perpetuate noncompliance and disrupt team dynamics. It is important to first clarify why the AP is unwilling before redirecting the task.

C. Notify the charge nurse immediately: Escalating to the charge nurse is appropriate if the issue cannot be resolved directly. However, the first action should be to attempt communication and resolution with the AP to encourage accountability and collaboration.

D. Discuss the AP's concerns about the task: This is the most appropriate initial response. By opening a discussion, the nurse can identify whether the refusal stems from a misunderstanding, lack of training, or legitimate concern, allowing for timely correction or education.