Question

Can someone help with all?

1. What are the early and late symptoms of Alcohol Withdrawal Syndrome. When should we assess for them?

2. What would you assess in a patient that you suspect is going through alcohol withdrawal?

3. What education can a nurse provide for someone who is unaware of the impact of their drinking?

4. What is Audit C and how is it clinically utilized?

5. Describe nursing interventions to help the patient having a Panic Attack

Answer 1

1. Symptoms will peak within the first 24 to 48 hours upon cessation with most uncomfortable of withdrawal symptoms, such as insomnia, rapid heartbeat, changes in blood pressure, sweating, tremors, and fever.

6- 12 hours post-ingestion

• Agitation
• Anxiety
• Headaches
• Shaking
• Nausea and vomiting

12 - 24 hours post-ingestion

• Disorientation
• Hand tremors
• Seizures

48 hours post-ingestion

• Seizures
• Insomnia
• High blood pressure
• Tactile, auditory, and visual hallucinations
• High fever and excessive sweating
• Delirium tremens

2. The assessment must be done on the patient health history, symptoms, and conduct a physical exam. Common signs are

• hand tremors
• an irregular heart rate
• dehydration
• a fever

Toxicology screening will be done to test the amount of alcohol in the body.

Alcohol Use Disorder Identification Test (AUDIT) asks about the amount of alcohol you consume, as well as your experience in using alcohol.

The Clinical Institute Withdrawal Assessment of Alcohol (CIWA-Ar) is a series of questions used to measure AWS.

3. Most people have a hard time distinguishing when "normal drinking" becomes problem drinking. In general, drinking is considered a problem when it starts to adversely affect a person's personal or professional life, or when the person loses control over his or her drinking. Women tend to have alcohol-related problems at lower drinking levels than men.

Alcohol abuse is common in people older than 65 and can be especially dangerous for them; alcohol can interact with medications and is responsible for many fall-related injuries. The alcohol and drug use can lead to car crashes, suicide and homicide even.

Teach about alcohol intoxication, alcohol use disorder and effect of alcohol on the health considering its impact on the internal organs.

Explain the conditions citing the signs and symptoms, the complications which can occur etc.

The nurse can explain it in the context of a patient who ended up in health problems due to alcohol intake.

4. AUDIT C is a 3 item alcohol screen that help to identify hazardous drinkers or those having active alcohol use disorders.

The scoring is done on a scale of 0-12, with each question having 5 answer choices
In men, a score of 4 or more is considered positive
In women a score of 3 or more is considered positive.
the increased score says the drinking is unsafe for the person.

5. The interventions for panic attack include:

• Maintain a calm, non threatening manner while working with the client.
• Establish and maintain a trusting relationship by listening to the client; displaying warmth, answering questions directly, offering unconditional acceptance; being available and respecting the client’s use of personal space.
• Remain with the client at all times when levels of anxiety are high (severe or panic); reassure client of his or her safety and security.
• Move the client to a quiet area with minimal stimuli such as a small room or seclusion area (dim lighting, few people, and so on.)
• Provide reassurance and comfort measures
• Educate the patient and/or SO that anxiety disorders are treatable.
• Support the client’s defenses initially.
• Avoid asking or forcing the client to make choices.
• PRN medications may be indicated for high levels of anxiety. Watch out for adverse side effects.
• Encourage the client’s participation in relaxation exercises such as deep breathing, progressive muscle relaxation, guided imagery, meditation and so forth.
• Teach signs and symptoms of escalating anxiety, and ways to interrupt its progression (e.g., relaxation techniques, deep- breathing exercises, physical exercises, brisk walks, jogging, meditation).
• Help the client see that mild anxiety can be a positive catalyst for change and does not need to be avoided.
• Administer SSRIs as ordered.
• Encourage client to talk about traumatic experience under nonthreatening conditions. Help client work through feelings of guilt related to the traumatic event. Help client understand that this was an event to which most people would have responded in like manner. Support client during flashbacks of the experience.