Question

Hello-

Discuss some assessment findings you expect to see in a client who is experiencing alcohol withdrawal, nursing interventions, medication therapy and referral options for this client. A minimum of 300 words is required as there are four different aspects of this question that need answered. Please don't forget whatever reference you look at. Or two...

Thank you for your help.

Answer 1

ALCOHOL WITHDRAWAL

If a person drinking alcohol heavily for weeks, months, or years, and may have both mental and physical problems when that person  stop or seriously cut back on how much he  drink. This is called alcohol withdrawal

NURSING INTERVENTION

Anxiety

May be related to

• Cessation of alcohol intake/physiological withdrawal
• Situational crisis (hospitalization)
• Threat to self-concept, perceived threat of death

INTERVENTION

Determine cause of anxiety, involving patient in the process. Explain that alcohol withdrawal increases anxiety and uneasiness. Reassess level of anxiety on an ongoing basis.

Develop a trusting relationship through frequent contact being honest and nonjudgmental. Project an accepting attitude about alcoholism.

Maintain a calm environment, minimizing noise.

Inform patient about what you plan to do and why. Include patient in planning process and provide choices when possible.

Sensory-Perceptual Alterations

May be related to

• Chemical alteration: Exogenous (e.g., alcohol consumption/sudden cessation) and endogenous (e.g., electrolyte imbalance, elevated ammonia and BUN)

INTERVENTION

Assess level of consciousness; ability to speak, response to stimuli and commands.

Observe behavioral responses such as hyperactivity, disorientation, confusion, sleeplessness, irritability.

Provide calm environment, minimizing noise and shadows.

Avoid restraining the patient unless necessary.

Provide quiet environment. Speak in calm, quiet voice. Regulate lighting as indicated. Turn off radio and TV during sleep.

Monitor patient for signs of depression.

Avoid bedside discussion about patient or topics unrelated to the patient that do not include the patient.

Risk for Injury

Risk factors may include

• Cessation of alcohol intake with varied autonomic nervous system responses to the system’s suddenly altered state

INTERVENTION

Identify stage of AWS (alcohol withdrawal syndrome); i.e., stage I is associated with signs and symptoms of hyperactivity (tremors, sleeplessness, nausea and vomiting, diaphoresis, tachycardia, hypertension). Stage II is manifested by increased hyperactivity plus hallucinations and seizure activity. Stage III symptoms include DTs and extreme autonomic hyperactivity with profound confusion, anxiety, insomnia, fever.

Monitor and document seizure activity. Maintain patent airway. Provide environmental safety (padded side rails, bed in low position).

Check deep-tendon reflexes. Assess gait, if possible.

Assist with ambulation and self-care activities as needed.

MEDICAL TREATMENT

Oral diazepam

chlorpromazine, hydroxyzine, thiamine or placebo