Question

PN 200 Fundamentals of Nursing II Alcohol Use - Dependency LM, a 57 year old man, is admitted to the surgical unit in preparation for back surgery. after conventional treatment for a recent back injury has not relieved his pain. His wife tells the nurse that she hopes that the surgery will be successful. She confides that her husband as just been sitting around the house, drinking more beer than usual, because he has not been able to work. LM appears relaxed and unconcerned about his upcoming surgery. He jokes with the nurse, telling her that his back would be cured if "a cute young thing like her, would rub his back." 1. What assessments of LM's alcohol use should the nurse make and communicate to the surgeon and anesthesiologist before he is further prepared for surgery? 2. How would the nurse's approximation of LM's BAC (blood alcohol content) affect his surgical experience? 3. During LM's postoperative period, when will the nurse expect signs of withdrawal syndrome to occur being sure to include your rationale for your answer? 4. What early signs and symptoms would alert the nurse to the development of withdrawal syndrome? 5. What drug regimens might be used during LM's postoperative period to manage problems associated with his alcohol use? 6. Prepare a list of medications that could be used if Mr. LM went into acute alcohol withdrawal Reviewed 10/19

Answer 1

1.The following assessment has to be done and informed to the surgeon and the anesthesiologist

• Last alcohol consumption (its should be stopped before 48 hours of surgery)
• The quantity of alcohol consumed to be asked because the alcohol in the body can interfere with the anesthesia administered if it is not completely eliminated or excreted from the body.
• Neurological examination ti assess the patients current status and conciousness in regards to the surrounding and the expected surgery
• Assess for alcohol withdrawal symptoms to prevent certain serious complications like seizure ,delirium
• In general
  • CNS: loss of memory ,confusion,irrelevant communication
  • Sensory: yellowing of sclera or red highs
  • GIT: nausea,vomiting
  • Musculoskeletal:tremors,muscle atrophy are evident in severe cases

2.This could affect the surgery by making it high risk and leading the patient to alcohol withdrawal syndrome during the surgery. This can increase the post operative complications.

3.The nurse can expect signs of withdrawal symptoms in the first 48 to 72 hours of surgery because the effect of alcohol by that time is completely low due to the counter reaction of anesthesia provided and making the patient to behave agitated to get the alcohol

4.The signs and symptoms which can observed in the patient are

• An elevated body temperature
• Confusion ,CNS disorientation ,agitation
• Increase in pulse rate,blood pressure