SJH Nursing Officer - 2019
Medical & Surgical Nursing
Medium
Which of the following foods would the nurse eliminate from the diet of a client in alcohol withdrawal?
Appeared in: SJH Nursing Officer - 2019
Explanation
- Regular coffee contains a significant amount of caffeine, a central nervous system (CNS) stimulant.
- Alcohol withdrawal causes CNS hyperexcitability, leading to symptoms like anxiety, tremors, insomnia, and tachycardia.
- Introducing a stimulant like caffeine can exacerbate these withdrawal symptoms, increasing patient discomfort and the risk of more severe complications like seizures.
- Therefore, eliminating coffee is a key nursing intervention to help stabilize the patient and manage withdrawal symptoms effectively.
Why Other Options Were Wrong
- Option A: Milk is a source of hydration, calories, and calcium. It does not contain stimulants and is generally soothing, making it a suitable choice.
- Option B: Orange juice provides hydration, calories, and essential nutrients like Vitamin C. It is not a stimulant and is generally beneficial.
- Option C: While tea does contain caffeine, the amount is typically much lower than in regular coffee (about one-third to one-half as much). Coffee is the more potent stimulant and therefore the priority for elimination.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Nutritional management during alcohol withdrawal to guide bedside assessment, documentation, and the next nursing action.
- Managing a patient's environment and diet is a crucial nursing role in alcohol withdrawal to prevent symptom escalation and ensure safety.
- Nurses should proactively educate patients and their families about the impact of substances like caffeine during withdrawal and offer suitable alternatives like decaffeinated beverages, water, and juices.
- Monitoring for withdrawal symptoms using a standardized tool like the CIWA-Ar scale is essential for titrating treatment and assessing the effectiveness of interventions, including dietary modifications.
How to Approach the Question
- First, identify the core of the question: It asks what to ELIMINATE from the diet of a client in alcohol withdrawal.
- Recall the pathophysiology of alcohol withdrawal. Chronic alcohol use suppresses the CNS. When alcohol is withdrawn, the CNS becomes hyperexcitable.
- Analyze the goal of nursing care in this state: to calm the CNS, manage symptoms (tremors, anxiety, tachycardia), and prevent complications (seizures, delirium tremens).
- Evaluate each food option based on its physiological effect in the context of a hyperexcitable CNS.
- Milk and Orange Juice: These are sources of nutrition and hydration without stimulant properties. They are helpful, not harmful.
- Tea and Regular Coffee: Both contain caffeine, a known CNS stimulant. A stimulant will counteract the goal of calming the CNS.
Concept Tested & Keywords
- Concept Tested: Nutritional management during alcohol withdrawal
- Stem keywords: eliminate, diet, client, alcohol withdrawal
- Lead-in keywords: Which
- Clinical cues: Patient condition: alcohol withdrawal, which implies CNS hyperexcitability.
Question ID
QoMh48IggsYOiSD_28HEFN
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 1010-1012, 1011-1013
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Attempt every question from this paper in a timed mock, then review the full solution for each one.
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