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Pharmacology-PH1031

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Chapter 07: Drugs of Abuse

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Chapter 07: Drugs of Abuse

LM, a 57-year-old man, is admitted to the surgical unit in preparation for back surgery after conservative treatment for a recent back injury failed to relieve his pain. His wife tells the nurse she hopes the surgery will be successful. She confides that her husband has 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 anticipated surgery. He jokes with the nurse, telling her that he would be cured if “a cute young thing like her would only 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. During LM’s postoperative period, when will the nurse expect signs of withdrawal syndrome to occur?

3. What early signs and symptoms would alert the nurse to the development of withdrawal syndrome?

4. What goal of treatment during LM’s postoperative period is related to alcohol withdrawal syndrome?

Answer 1

1. ANS: The patient alcohol consumption must be informed to anesthesiologist to provide the appropriate dosage of anesthesia to the patient. The blood alcohol concentration must be checked before operation and informed to surgeon. Since blood alcohol concentration must be less than 200 mg% before performing surgery or else the surgery need to be postponed. If blood alcohol concentration is more than 200 mg % there is a high possibility of surgical risk and mortality rate.

2. ANS: According to the patient postoperative period situation the affect of both alcohol and anesthesia is over, Mr. LM will have the withdrawal symptoms. The alcohol withdrawal syndrome can be initiated by surgery, since the alcohol consumption is stopped from surgery to his postoperative period. The Indications of withdrawal syndrome may be delayed till he recovers from the effect of anesthesia and other pain medications used during surgery. The nurse can expect the indications of withdrawal syndrome for up to 5 days post operatively.

3. ANS: Alcohol withdrawal early signs and symptoms:

Anxiety

Irritability

Tremors

Rapid changes of emotions

Fatigue

4. ANS: The syndrome can be addressed by reducing the consumption of alcohol slowly with supportive care. The treatment plan must be developed with the patient and should compromise description for pain management and made as transcribed promise by the patient. It should also include the steady narrowing of analgesic dose and substitution of longer acting oral parenteral analgesics.

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