- Monitor vital signs every 15 minutes initially and less fre-6. Ensure that smoking materials and other potentially harmful^ 5. Institute necessary safety precautions. 4. Place client in quiet room, if possible. 3. Obtain urine sample for laboratory analysis of substance^368 nursing priority. content. regarding substance ingestion is important for accurate as-sessment of client condition. d. Amount consumed on a daily basis. need for medication during acute detoxificrease client agitation. c. Duration and frequency of consumption.self or others in disoriented, confused state.quently as acute symptoms subside. a. Observe client behaviors frequently; assign staff on one-most reliable information regarding client condition and b. Be sure that side rails are up when client is in bed. c. Pad headboard and side rails of bed with thick towels to d. Use mechanical restraints as necessary to protect client if objects are stored outside client’s access.^ ●long distances.excessive hyperactivity accompanies the disorientation. to-one basis if condition warrants it; accompany and assist client when ambulating; use wheelchair for transporting protect client in case of seizure.^ SPECIAL TOPICS IN PSYCHIATRICSubjective history often is not accurate. Knowledge Vital signs provide the Excessive stimuli in- Client safety is a cation period.Client may harm
2 2506_Ch22_358-369.indd Sec1:368 506 Ch 22 358 - 369 .ind^ 8. Follow medication regimen, as ordered by physician. Com-d S b. lowing substances include:mon medical interventions for detoxifi a. ec 1 :the shorter-acting benzodiazepine, oxazepam (Serax), is azepoxide (Librium), may be problematic, and the use of cumulation of the longer-acting agents, such as chlordi-withdrawal is complete. In clients with liver disease, ac-doses and reduce the dosage by 20% to 25% each day until The approach to treatment is to start with relatively high of drugs for substitution therapy in alcohol withdrawal. propoxyphene (Darvon) for weaker effects or methadoneAlcoholnaltrexone (ReVia), or nalmefene (Revex), are admin-istered for opioid intoxication. Withdrawal is managed Narcotics.may be instituted to decrease withdrawal symptoms using tion), is common protocol.combination with daily thiamine (either orally or by injec-is not a universal intervention. Multivitamin therapy, in with rest and nutritional therapy. Substitution therapy sant medication to be used prophylactically; however, this more appropriate. Some physicians may order anticonvul- 368. Benzodiazepines are the most widely used group Narcot ic antagonists, such as naloxone ( Narcan), cation from the fol- 10/1/10 9:38:17 AM 10 / 1 / 10 9 : 38 : 17 AM
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