Comprehensive exams for Mental Health Q 203
Joy has entered the chemical dependency unit for treatment of alcohol dependency. Which of the following client’s possessions will the nurse most likely place in a locked area?
A. Toothpaste
B. Shampoo
C. Antiseptic wash
D. Moisturizer
Correct Answer: C. Antiseptic wash
Antiseptic mouthwash often contains alcohol & should be kept in a locked area, unless labeling clearly indicates that the product does not contain alcohol. Alcohol misuse has been linked to numerous social, economic, and health problems. Estimates vary but have suggested that up to 40% of patients have experienced complications of alcohol misuse. In the United States, 138.3 million people aged 12 and older, surveyed, report that they actively use alcohol, according to the 2015 National Survey on Drug Use and Health. Of those, 48.2% report that they had binge drinking episode(s) within 30 days before taking the survey. Of those who reported binge drinking, 26% reported heavy alcohol use, defined as binge drinking five or more days in the previous 30 days, which accounts for 12.5% of total alcohol users.
Option A: History gathering will often reveal reported episodes of binge drinking of four or five or more drinks at a time. Use of the CAGE questionnaire will reveal a score of 2 or greater (CAGE means (1) have you ever felt you should Cut down on your drinking, (2) have you ever been Annoyed by people criticizing your drinking, (3) have you ever felt Guilty about your alcohol use, or (4) have you ever needed an Eye-opener to steady your nerves or get rid of a hangover).
Option B: The patient may also report frequent falls, blackout spells, unsteadiness, or visual disturbances. They may report seizures if they went a few days without drinking, or tremors, confusion, emotional disturbances, and frequent job changes. They may also report social issues, such as job termination, separation/divorce, estrangement from family, or loss of their home. They may also report sleep disturbances.
Option D: On exams, they may exhibit signs of cerebellar dysfunction, such as ataxia or difficulty with fine motor skills. They may exhibit slurred speech, tachycardia, memory impairment, nystagmus, disinhibited behavior, or hypotension. They may present with tremors, confusion/mental status changes, asterixis, ruddy palms, jaundice, ascites, or other signs of advanced liver disease. There may also be spider angiomata, hepatomegaly/splenomegaly (early; liver becomes cirrhotic and shrunken in advanced disease).