A 68-year-old hospitalized client with a history of alcohol use abruptly ceases drinking and begins to exhibit severe tremors, confusion, and agitation. What is the priority nursing intervention?

Rationale: A. Monitoring is important in alcohol withdrawal, but every 24 hours is too infrequent for a high-risk client exhibiting severe symptoms. Neurological status should be assessed frequently to detect rapid deterioration, but monitoring alone is not the priority intervention. B. Hydration is supportive and can help prevent electrolyte imbalances, but it does not address the immediate risk of severe alcohol withdrawal complications, including delirium tremens or Wernicke’s encephalopathy. C. This is the priority intervention. Abrupt cessation of alcohol in chronic users can lead to thiamine deficiency, putting the client at risk for Wernicke’s encephalopathy and worsening neurological symptoms. IV thiamine replenishes deficient stores rapidly, reduces the risk of permanent brain damage, and is a cornerstone of managing severe alcohol withdrawal alongside benzodiazepines for agitation and autonomic hyperactivity. D. Physical restraints are not first-line and should only be considered as a last resort if the client is an immediate danger to self or others. Early pharmacologic and supportive interventions are preferred to manage agitation safely.