The nurse in the Emergency Department (ED) assesses a 17-year-old patient with blue-tinged lips, slowed respirations, and pinpoint pupils. The patient has no response to painful stimuli. Which of the following should be the nurse’s priority action?

Choice A Reason: Prevents Extrapyramidal Side Effects

Extrapyramidal side effects (EPS) are drug-induced movement disorders that include symptoms such as tremors, rigidity, bradykinesia, and tardive dyskinesia. These side effects are commonly associated with first-generation antipsychotics. While second-generation antipsychotics like olanzapine have a lower risk of causing EPS, their primary use in this context is not to prevent these side effects. Therefore, this choice is not the most appropriate response to the family’s question.

Choice B Reason: Reduces Agitation Until the Lithium Takes Effect

Olanzapine is a second-generation antipsychotic that is effective in managing acute agitation and psychotic symptoms in patients with bipolar disorder. Lithium, while effective for long-term mood stabilization, takes several days to weeks to reach therapeutic levels and exert its full effect. During this period, olanzapine can help reduce the client’s agitation and stabilize their mood. This makes it the most appropriate response to the family’s question.

Choice C Reason: Cures Manic Symptoms

While olanzapine can help manage manic symptoms, it does not “cure” them. Bipolar disorder is a chronic condition that requires ongoing management with medications and therapy. The term “cure” is misleading as it implies a permanent resolution of symptoms, which is not the case with bipolar disorder. Therefore, this choice is not accurate.

Choice D Reason: Ensures High-Quality Sleep

Olanzapine can have sedative effects and may help improve sleep in some patients. However, its primary use in this scenario is to manage acute agitation and psychotic symptoms rather than to ensure high-quality sleep. While improved sleep may be a beneficial side effect, it is not the main reason for its prescription in this context.

Choice A Reason: Encouraging the client to consume foods high in vitamin B1 (thiamine) is beneficial, but it may not be sufficient alone to prevent Korsakoff’s syndrome in individuals with alcohol use disorder. Thiamine is crucial for brain function, and its deficiency can lead to Wernicke-Korsakoff syndrome. However, due to malabsorption issues common in alcohol use disorder, dietary intake alone might not meet the necessary thiamine levels.

Choice B Reason: Implementing strict bed rest to conserve energy is not directly related to preventing Korsakoff’s syndrome. While rest is important for overall health, it does not address the thiamine deficiency that leads to this condition. Korsakoff’s syndrome is primarily caused by a lack of thiamine, and conserving energy does not mitigate this deficiency.

Choice C Reason: Restricting fluid intake to prevent water intoxication is not relevant to preventing Korsakoff’s syndrome. Water intoxication is a separate issue and does not address the thiamine deficiency that causes Korsakoff’s syndrome. Proper hydration is important, but it does not prevent the neurological damage associated with thiamine deficiency.

Choice D Reason: Administering thiamine supplements as prescribed is the most appropriate intervention to prevent Korsakoff’s syndrome. Thiamine supplementation is crucial for individuals with alcohol use disorder because their bodies often cannot absorb enough thiamine from food alone. Thiamine is essential for brain function, and its deficiency can lead to severe neurological damage. Administering supplements ensures that the client receives an adequate amount of this vital nutrient.