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Alcohol Withdrawal Final
Transcript of Alcohol Withdrawal Final
Patients are also at an increased risk for suicidal and homicidal ideation
Signs and Symptoms
Michigan Alcoholism Screening Test
May be used for initial assessment as well as ongoing monitoring of alcohol withdrawal symptoms
Nursing Care Plan
Most hospital also check blood alcohol levels and screen for other drug usage
Anti-Alcohol agent: Disulfiram
Substitution Therapy: Valium, Librium
Ammonia reducer: Lactulose
Vitamin Therapy: B1-Thamine
Adult Children of Alcoholics
Women for Sobriety
Nursing Nanda # 3
RT Delirium and Substance abuse withdrawal
AEB changes in cognition, altered mental status, impaired perceptions, AAOx2.
Nursing Nanda # 2
Disturbed Sensory Perception
RT altered sensory reception and biochemical imbalances
AEB altered mental status, global confusion, substance abuse, poor concentration, disorientation, impaired communication, altered sense of balance, abnormal chemistry panel and CBC blood profiles
Risk for Injury
RT sensory dysfunction
AEB altered mental status, global confusion, disorientation, muscle rigidity, tremors, altered sense of balance, unsteady gait
Assess mental status for symptoms such as anxiety, disorientation, tremors, hallucinations, delusions, and incoherence.
Implement helpful communication measures such as speaking slowly and clearly and using short, simple sentences.
Explain reason for confusion and provide appropriate referrals such as substance abuse support groups.
Disturbed Sensory Perception
Assess ability to speak, hear, interpret, and respond to simple commands to obtain an overview of the client’s mental and cognitive status and ability to interpret stimuli
Reorient to time, place, and situation or events, as necessary, to reduce confusion and provide sense of normalcy.
Make sure call bell is in within reach and be sure client knows where it is and how to use it
Review, with patient, ways to prevent or limit exposure to conditions affecting sensory function and the production of delirium tremens
Risk for Injury
Assess stage of AWS and monitor/document seizure activity.
Maintain airway patency and provide environmental safety.
Assist patient with ambulation and self-care activities as needed
Encourage patient to use to the call bell when assistance is needed for ambulating.
Nursing Nanda # 1
Client will verbalize need for assistance and demonstrate proper use of call bell for assistance when nurse is not present in patient’s room to prevent injury/harm upon self throughout shift
Patient will be free of Delirium Tremens experienced from alcohol withdrawal
Client will verbalize understanding of the cause of his Delirium Tremens 1 hr after teaching.
Client will regain and then maintain usual level of cognition once Delirium Tremen has subsided within shift.
Patient: 48 M Caucasian
Condition: Seizures secondary to eTOH withdrawal
AAO X 2, Vital Signs of: BP: 122/80 T: 98.3 HR:87 RR: 20 O2: 96%
His neighbor found him lying on the ground in the front lawn of his home in a postictal state
Restless, confused, disoriented
Dry skin, wrinkles, matted hair, stained yellow/black teeth
Unclear, slurry speech
Head trauma from previous DT’s
Ulcer with GI bleed
Patient Presents as
No Support from family and friends
"falling out of relationship with my siblings"
No motivation to seek employment
No job due to lack of effort
Low socioeconomic status
PT: 14.6 H
Ammonia: 104 H
Includes: commitment to abstinence, self responsibility, and attendance of self help groups and therapy
Kasser, C., Geller, A., Howell, E., & Wartenberg, A. (2004). Detoxification: Principles and protocols. Chevy Chase, MD: American Society of addiction Medicine.
Laffan, S, (2013). Dangers of Alcohol Withdrawal. American Jails. pp.17-19
Schuckit, M. (2008). Alcohol and alcoholism. In A. Fauci, D. Kasper, D. Longo, E. Braunwald, S. Hauser, J. Jameson, & J. Loscatzo (Eds.) Harrison’s principles of internal medicine (17th ed.) (pp.2724-2729). Philadelphia, PA: McGraw Hill.
Townsend, M, (2011). Essentials of Psychiatric Mental Health Nursing. 5th ed. Philadelphia: F.A. Davis Company.