A nurse is caring for a client who has right-sided hemiplegia following a recent stroke. Which of the following questions should the nurse ask to determine the client's ability to cope?

a. Methadone 40 mg PO daily: This is contraindicated. Methadone is primarily used for opioid withdrawal and maintenance, not for alcohol withdrawal.

b. Nutritional consult: This is anticipated. Nutritional therapy can help balance out the loss of nutrients due to heavy drinking.

c. Perform Alcohol Use Disorders Identification Test (AUDIT): This is contraindicated. AUDIT is a screening tool for assessing alcohol consumption and related problems, but it’s not typically used once a diagnosis of alcohol use disorder has been established and the patient is in withdrawal.

d. Complete blood count and basic metabolic profile: This is anticipated. These tests can help assess the patient’s overall health status and identify any potential complications related to alcohol withdrawal67.

e. Group therapy: This is anticipated. Group therapy can provide peer support and is often beneficial in the treatment of alcohol use disorder.

f. Schedule electroconvulsive therapy (ECT): This is contraindicated. ECT is typically used for severe depression and other psychiatric disorders, not for alcohol withdrawal.

g. Diazepam 10 mg PO three times a day: This is anticipated. Diazepam, a benzodiazepine, is commonly used in the management of alcohol withdrawal to reduce symptoms and prevent complications.

h. Propranolol 40 mg PO twice a day: This is contraindicated. Propranolol, a beta-blocker, is not typically used as a first-line treatment for alcohol withdrawal. It may be used to manage some symptoms such as tremors or high blood pressure, but it does not prevent seizures, a potential complication of alcohol withdrawal.

Choice A reason:
Informing the client about confidentiality rights is an essential part of the initial orientation phase of a therapeutic relationship. This is when the nurse and client establish the parameters of the relationship, including confidentiality. However, this is not typically a task for the working phase.

Choice B reason:
During the working phase of a therapeutic relationship, the nurse's primary task is to evaluate progress toward predetermined goals. This phase involves active problem-solving and implementing nursing interventions. The nurse and client work together to address problems and issues, and it is crucial to assess whether the interventions are effective and if the goals are being met.

Choice C reason:
Establishing boundaries between the nurse and the client is another task that occurs during the orientation phase. Clear boundaries are necessary for a professional and therapeutic relationship, but they are set at the beginning and maintained throughout the relationship, not just during the working phase.

Choice D reason:
Setting short- and long-term objectives is part of both the orientation and working phases. While objectives may be initially set during the orientation phase, they can be revisited and adjusted during the working phase as needed. However, the primary focus of the working phase is on evaluating progress, not setting objectives.