Comprehensive exams for Mental Health Q 206
Which of the following assessments would provide the best information about the client’s physiologic response and the effectiveness of the medication prescribed specifically for alcohol withdrawal?
A. Sleeping pattern
B. Mental alertness
C. Nutritional status
D. Vital signs
Correct Answer: D. Vital signs
Monitoring of vital signs provides the best information about the client’s overall physiologic status during alcohol withdrawal & the physiologic response to the medication used. Alcohol withdrawal symptoms occur when patients stop drinking or significantly decrease their alcohol intake after long-term dependence. Withdrawal has a broad range of symptoms from mild tremors to a condition called delirium tremens, which results in seizures and could progress to death if not recognized and treated promptly. The reported mortality rates for patients who experience delirium tremens is anywhere from 1-5%.
Option A: Alcohol withdrawal can range from very mild symptoms to the severe form, which is named delirium tremens. The hallmark is autonomic dysfunction resulting from the excitation of the central nervous system. Mild signs/symptoms can arise within six hours of alcohol cessation. If symptoms do not progress to more severe symptoms within 24 to 48 hours, the patient will likely recover.
Option B: Nurses monitoring alcoholic patients should be familiar with signs and symptoms of alcohol withdrawal and communicate to the interprofessional team if there are any deviations from normal. In most cases, the symptoms are autonomic. For those who develop delirium tremens, monitoring in a quiet room is recommended.
Option C: Patients should be kept calm in a controlled environment to try to reduce the risks of progression from mild symptoms to hallucinations. With mild to moderate symptoms, patients should receive supportive therapy in the form of intravenous rehydration, correction of electrolyte abnormalities, and have comorbid conditions as listed above ruled out. Due to the risk of a comorbid condition called Wernicke-Korsakoff syndrome, patients can also receive a “banana bag” or cocktail of folate, thiamine, dextrose containing fluids, and multivitamin.