Which of the following would the nurse recognize as signs of alcohol withdrawal? Select all that apply.

Choice A reason: Lethargy is not a typical sign of alcohol withdrawal. Instead, withdrawal is characterized by hyperactivity of the autonomic nervous system, not sedation or fatigue. Lethargy is more often seen with intoxication rather than withdrawal. Choice B reason: Blackouts occur during episodes of heavy drinking due to acute intoxication and memory impairment, not during withdrawal. Withdrawal symptoms are related to the absence of alcohol and the rebound hyperexcitability of the nervous system. Choice C reason: Nausea is a common symptom of alcohol withdrawal. The gastrointestinal system becomes irritated, and autonomic hyperactivity contributes to nausea and vomiting. This is a well-recognized clinical feature. Choice D reason: Tremulousness, or hand tremors, is one of the hallmark signs of alcohol withdrawal. It results from central nervous system hyperexcitability when alcohol is abruptly discontinued. Tremors are often the first noticeable symptom. Choice E reason: Diaphoresis, or excessive sweating, is a classic autonomic symptom of alcohol withdrawal. It reflects increased sympathetic nervous system activity, which is a direct consequence of withdrawal. Choice F reason: Elevated blood pressure is another autonomic sign of alcohol withdrawal. The absence of alcohol leads to increased sympathetic tone, causing hypertension and tachycardia. This is a critical sign to monitor because it can progress to more severe complications such as seizures or delirium tremens.