Explanation:

The symptoms described by this patient put his alcohol use in the category of substance dependency, according to the DSM V, a more severe form of abuse than substance addiction. The criteria for this condition are:

1. Tolerance 
2. Withdrawal
3. Unintentional excesses in consumption
4. Persistent desire or unsuccessful efforts to reduce or control substance use
5. A great deal of time is spent to get, use, or recover from the substance
6. Interference with social life
7. The substance use is continued despite knowledge problems caused by use

Explanation:

Prolonged alcohol abuse can result in a severe deficiency in thiamine, or vitamin B1 by reducing dietary thiamine intake, impairing gastrointestinal absorption of thiamine, and causing impaired thiamine utilization in cells. Note that individuals who partake in prolonged alcohol abuse may have various other dietary deficiencies.

Explanation:

Delirium tremens (DT) is a rapid onset of confusion seen during alcohol withdrawal. The symptoms of DT include altered mental status, autonomic instability, and even seizures. DT is also characterized by hallucinations such as the sensation of something "crawling" on the patient. DT is the most severe consequence of withdrawal and can be fatal if untreated.

Explanation: Confrontational behavior is very common for a client in the termination phase. The nurse should not assume that she offended the client, and further action in terms of therapy should not be addressed until completing the termination phase.

Explanation: During the orientation phase the nurse should establish acceptance, trust, and boundaries with the client, which will be built upon in later phases.

Explanation: Acceptance, trust, and boundaries are established in the orientation phase of therapy.

Explanation:

Conversion disorder is typified by numbness, paralysis, loss of vision, or other neurological symptoms after a traumatic or stressful event, without any identifiable medical cause. Schizophrenia, bipolar disorder, and stiff person syndrome all have medically identifiable causes. 

Explanation:

Delirium is an organic dysfunction of the brain usually seen in sick patients post-op. These patients need frequent reorientation to name, time, and place until the delirium resolves. Agitation, confusion, and difficult to control behavior is typically controlled with antipsychotics, however, they are not first line treatment. Restraints should be avoided at all costs.

Explanation:

All of these are important professional roles of the nurse in a healthcare setting.

Explanation:

The correct answer is "immediately inform the covering physician." This is the correct choice because in this case, a medical error was committed, and the most appropriate immediate course of action is to let the patient's covering physician know, so that they can determine what effect this may have on the patient, assess the patient, and determine what, if any, immediate intervention needs to be performed to ensure that the adverse effect on the patient is minimized. 

While it is possible in this case, given that the patient has congestive heart failure, and that they may have been fluid overloaded by the administration of excess fluids, that they will need to be diuresed with furosemide, this medication cannot be administered without the order of the covering physician, and it would be inappropriate to administer furosemide without their orders. 

While your hospital's safety oversight committee may ultimately need to be informed of this incident, the most immediate priority is patient safety, and as such, the patient's physician should be notified of the medical error before anyone else so that they can best manage any immediate consequences of the error. 

It would be highly inappropriate to not inform anyone of the error, as an unintended dose of IV fluids was administered and this can be dangerous in a patient with congestive heart failure. Any delay, whether due to not telling anyone, or to conferring with co-nurses, in informing the supervising physician would be inappropriate and potentially dangerous to the patient.