Instructions Patient Case Study #11 – Alcohol Withdrawal Team #11 – Read the following case and answer to the best of your ability the questions at the end. You will need to research the disease or disorder, medications, treatments, interventions, diagnostics, symptoms, medical terms and outcomes on your own. You may use the internet or nursing, lab and diagnostic and medication textbooks or articles, but your research must include at least 4-5 reliable resources such as those used in your research essay. The sources your team uses must be academic sources, geared towards healthcare professionals. The sources you provide for your patients must be written to a lay or general audience. How your team plans, collaborates and organizes the work on this project is to be decided on by the team, but as individual members, don’t forget to answer question #13 at the end. Alcohol Withdrawal Name: Jennifer Perry Gender: Female Age: 37 Ethnicity: Caucasian Setting: Hospital Pre-existing Condition: Alcohol abuse for 15 years Co-existing Condition: Pancreatitis Socioeconomic: Married, stay at home mother of two children 11 and 14 years old Mrs. Perry is a 37-year old woman admitted to the hospital with pancreatitis. During her stay, Mrs. Perry experiences alcohol withdrawal. Scenario: Mrs. Jennifer Perry arrives at the Emergency Department with complaints of severe abdominal pain. She is admitted to the nursing unit at noon with a diagnosis of pancreatitis. While completing the nursing admission assessment, the patient tells the RN, ?I probably drink at least a case of beer every week, maybe more.? She states her last drink was this morning. While doing rounds, the evening RN nurse notices that Mrs. Perry has tremors and is very anxious and restless. Her vital signs are blood pressure 145/82, pulse 98, respiratory rate 18 and temperature 99.60 F. The nurse is concerned that the patient is going through alcohol withdrawals and notifies the MD. Daily folic acid and thiamine are prescribed along with lorazepam as needed. Questions: (Points for all questions will be awarded to all members with the exception of Question #13 which earns two individual grades.) 1. Discuss the classification, metabolism, and excretion of ethyl alcohol in the human body. 2. Provide a definition for each of the following terms associated with alcohol use: 3. What are the characteristic effects of alcohol on the major body systems including cardiovascular, gastrointestinal, neurological, renal, and respiratory? 4. Discuss the potential life-threatening complications associated with acute alcohol intoxication. What causes these complications? 5. When should the RN expect the manifestations of alcohol withdrawal to begin and what symptoms will the nurse anticipate in the next few days? 6. What are delirium tremens (DT?s)? Discuss the life-threatening complications of DT?s. 7. Why is lorazepam (Ativan) prescribed as part of the management of Mrs. Perry?s alcohol withdrawal? Discuss the most effective administration schedule of Ativan for Mrs. Perry? 8. Provide a rationale for the prescription of folic acid (folate, vitamin B) and thiamine (Vitamin B1) in the management of alcohol withdrawal. 9. What is considered the legal blood alcohol intoxication level in most of the United States? 10. What is alcoholic liver disease and how is it treated? 11. What is alcoholism and how is it treated? 12. What is the Johns Hopkins University test for alcoholism, and how valid is it in determining which patients are alcoholics? What I found, you can add more if you can find it. The Johns Hopkins Twenty Questions: Are You An Alcoholic? Was developed in the 1930s by Dr. Robert Seliger, who at that time was a faculty member in the Department of Psychiatry at the Johns Hopkins Hospital. It was intended for use as a self-assessment questionnaire to determine the extent of one’s alcohol consumption. It was not intended to be used by professionals as a screening tool to help them formulate a diagnosis of alcoholism in their patients. John Hopkin?s does not give permission to align the name of their institution to the use of this questionnaire nor do they recommend the use of it. 13. Provide and discuss the contents of at least three internet resources you can recommend to Mrs. Perry and her husband that will provide them with more information about alcoholism, its treatment and its impact on the family.
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