A home care client who has been identified as drinking a six-pack of beer daily tells the community

Question

mental health nurse

that his arthritis has been "acting up" recently and he is taking acetaminophen
arthritis formula four times daily for pain. The priority interventions the nurse should take include
(more than one option may be correct)
A. determining the safety of the dose the client is ingesting daily.
B. advising the client of the harmful effect of alcohol and acetaminophen on the liver.
C. suggesting increasing the acetaminophen dose because alcohol causes faster excretion.
D. inquiring about sleep disturbance caused by mixing alcohol and analgesics.
E. assessing for declining functional status associated with medication-induced dementia.

Answer 1

A, B
Rationale: The nurse should be concerned with the client's use of alcohol and acetaminophen
because the toxicity of acetaminophen is enhanced by alcohol and by the age-related decrease in
clearance. The nurse must determine whether the acetaminophen dose is within safe limits or is
excessive and provide this information to the client. Next, the nurse must provide health education
regarding the danger of combined use of acetaminophen and alcohol. The client will likely need to
discontinue alcohol or consult the physician about another analgesic that is less hepatotoxic. Option
C: This would cause greater liver damage. Option D: This is not a current priority. Option E: This is
not a priority.