Psychiatric Medications Q 24
What is Nurse John likely to note in a male client being admitted for alcohol withdrawal?
A. Perceptual disorders
B. Impending coma
C. Recent alcohol intake
D. Depression with mutism
Correct Answer: A. Perceptual disorders
Frightening visual hallucinations are especially common in clients experiencing alcohol withdrawal. This symptom usually begins within 12 to 24 hours after your last drink, and may last as long as 2 days once it begins. If this happens, you hallucinate (see or feel things that are not real). It is common for people who are withdrawing from alcohol to see multiple small, similar, moving objects. Sometimes the vision is perceived to be crawling insects or falling coins. It is possible for an alcohol withdrawal hallucination to be a very detailed and imaginative vision.
Option B: Delirium tremens commonly begins two to three days after the last alcohol drink, but it may be delayed more than a week. Its peak intensity is usually four to five days after the last drink. This condition causes dangerous shifts in your breathing, your circulation and your temperature control. It can cause your heart to race dangerously or can cause your blood pressure to increase dramatically, and it can cause dangerous dehydration. Delirium tremens also can temporarily reduce the amount of blood flow to your brain. Symptoms can include confusion, disorientation, stupor or loss of consciousness, nervous or angry behavior, irrational beliefs, soaking sweats, sleep disturbances and hallucinations. Alcohol withdrawal is common, but delirium tremens only occur in 5% of people who have alcohol withdrawal. Delirium tremens is dangerous, killing as many as 1 out of every 20 people who develop its symptoms.
Option C: After withdrawal is complete, it is essential that you not begin drinking again. Alcohol treatment programs are important because they improve your chances of successfully staying off of alcohol. Only about 20 percent of alcoholics are able to abstain from alcohol permanently without the help of formal treatment or self-help programs such as Alcoholics Anonymous (AA). Of people who attend AA, 44 percent of those who remain free of alcohol for 1 year probably will remain abstinent for another year. This figure increases to 91% for those who have remained abstinent and have attended AA for 5 years or more.
Option D: Alcohol has a slowing effect (also called a sedating effect or depressant effect) on the brain. In a heavy, long-term drinker, the brain is almost continually exposed to the depressant effect of alcohol. Over time, the brain adjusts its own chemistry to compensate for the effect of the alcohol. It does this by producing naturally stimulating chemicals (such as serotonin or norepinephrine, which is a relative of adrenaline) in larger quantities than normal. If the alcohol is withdrawn suddenly, the brain is like an accelerated vehicle that has lost its brakes. Not surprisingly, most symptoms of withdrawal are symptoms that occur when the brain is overstimulated.