NURS 432 Jonathan Herman | Interview the Patient | Review

NURS 432 Jonathan Herman | Interview the Patient | Review

Answers and Rationale

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1.

How long have you had a problem with alcohol?

Rationale

Relevancy

Your Answer

Because the criteria for withdrawal reflects cessation of (or reduction of) heavy and prolonged substance abuse, it is important to determine the length of use.

Relevant

Relevant

Client’s Mother: Jonathan’s drinking has been out of control for at least 7 years. He is a binge drinker. Sometimes he is able to control his drinking and then he has periods when he drinks heavily for several weeks at a time. Recently, he lost 25 pounds, broke up with his girlfriend, and was charged with DUI but kept drinking and then I have to look after him.

Client: I have tried to quit before, but just can’t seem to stop. When my life gets out of control and is so stressful, I need it just to get through the day.

2.

Do you only drink alcohol, or have you also used other substances?

Rationale

Relevancy

Your Answer

It is important to determine if the client has used or is using other substances.

Relevant

Relevant

Client’s Mother: Jonathan told me he only drank alcohol. He said he had never touched any other type of drug.

Client: I have never used any other drugs or substances.

3.

Have you ever tried to cut down on your drinking?

Rationale

Relevanc y

Your Answer

It has already been established that Jonathan began withdrawal symptoms when he abruptly quit drinking. It is not necessary to repeat gathering information on this portion of the history. The nurse should concentrate on the withdrawal symptoms for which Jonathan is admitted.

Irrelevant

Irrelevant

Client’s Mother: Several times, and he has been for court mandated treatment in the

past. He comes home and starts drinking again. I have had to call in sick for him when he is still too drunk to go to work.

4.

Do you feel that you have needed more alcohol in recent months in order to become intoxicated?

Rationale

Relevancy

Your Answer

It has already been established that Jonathan has substance dependence. It is not necessary to repeat gathering information on this portion of the history. The nurse should concentrate on the withdrawal symptoms for which Jonathan is admitted.

Irrelevant

Irrelevant

Client’s Mother: Yes, he seemed to continue to drink more and more. Sometimes I find bottles of alcohol hidden in the basement, so I hide them where he cannot find them. At other times he has gone to a motel and spent several days there drinking. I’ve had to drive around to find him and bring him home to sober him up.

5.

Have you lost jobs or employment opportunities as a result of your drinking?

Rationale

Relevanc y

Your Answer

Substance abuse is characterized by failure to fulfill a major role obligation (e.g., his role as a carpenter). Because Jonathan has already been diagnosed with a substance abuse problem, it is not necessary to repeat gathering information on this portion of the history. The nurse should concentrate on the withdrawal symptoms for which Jonathan is admitted.

Irrelevant

Irrelevan t

Client’s Mother: Yes, he has lost some very good jobs. Employers say he is a good worker but he has been fired for drinking on the job. He lost his latest job a couple of weeks ago when he was caught drinking at work. Then his girlfriend broke up with him.