Question

Mr. Zimmerman is a 56-year-old married Caucasian man who has been admitted for a compound fracture to his femur. About eight hours after admission he begins to appear agitated and has fine tremors. About 24 hours after admission, he is vomiting, has a coarse tremor, is diaphoretic, and reports visual and tactile hallucinations. The nurse reviews his history and determines she should ask further questions regarding:

1 history of seizure disorder
2 history of alcohol intake
3 history of domestic violence
4 possible exposure to heavy metals

Answer 1

The nurse should inquire about Mr. Zimmerman's history of alcohol intake, as his symptoms suggest alcohol withdrawal syndrome, which aligns with his presentation after admission. His medical history of epilepsy is also noteworthy but is not the immediate concern related to his current symptoms.

Step-by-step explanation:

Given Mr. Zimmerman's presentation of agitation, fine tremors, vomiting, coarse tremor, diaphoresis, and visual and tactile hallucinations, the nurse should inquire further about history of alcohol intake. His symptoms are indicative of alcohol withdrawal syndrome, which usually occurs in individuals with a history of heavy drinking upon sudden cessation of or reduction in alcohol consumption. The symptoms can start as early as hours after the last drink and may include seizures, hallucinations, and tremors, amongst other symptoms. Considering the patient's medical history that includes development of epilepsy, a condition characterized by recurrent seizures, this information is vital. However, the more pressing concern in relation to his recent symptoms is his potential alcohol intake history, which can help the medical team provide appropriate treatment for alcohol withdrawal.