Psychiatric Medications Q 18


Within a few hours of alcohol withdrawal, nurse John should assess the male client for the presence of:
  
     A. Disorientation, paranoia, tachycardia
     B. Tremors, fever, profuse diaphoresis
     C. Irritability, heightened alertness, jerky movements
     D. Yawning, anxiety, convulsions
    
    

Correct Answer: C. Irritability, heightened alertness, jerky movements
Alcohol is a central nervous system depressant. These symptoms are the body’s neurological adaptation to the withdrawal of alcohol. 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.
Option A: Alcohol withdrawal can range from very mild symptoms to 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: Mild symptoms can be insomnia, tremulousness, hyperreflexia, anxiety, gastrointestinal upset, headache, palpitations. Moderate symptoms include alcohol withdrawal seizures (rum fits) that can occur 12 to 24 hours after cessation of alcohol and are typically generalized in nature. There is a 3% incidence of status epilepticus in these patients. About 50% of patients who have had a withdrawal seizure will progress to delirium tremens.
Option D: Delirium tremens is the most severe form of alcohol withdrawal, and its hallmark is that of an altered sensorium with significant autonomic dysfunction and vital sign abnormalities. It includes visual hallucinations, tachycardia, hypertension, hyperthermia, agitation, and diaphoresis. Symptoms of delirium tremens can last up to seven days after alcohol cessation and may last even longer.