Assessment for alcohol withdrawal

  1. 0 I am hoping someone can clear up some confusion for me.

    Situation: A patient comes into your ER and is experiencing signs of alcohol withdrawal. As a nurse which would be your first priority:

    A) Assess if patient is taking any other substances or
    B) Ask patient for Date and Time of last drink

    Thank you
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  3. Visit  pinksapphire} profile page

    About pinksapphire

    From 'Davidsonville, MD, USA'; Joined Sep '11; Posts: 32; Likes: 12.

    12 Comments so far...

  4. Visit  hodgieRN} profile page
    0
    Is this homework? Tell us what you think about the answers.....
  5. Visit  pinksapphire} profile page
    1
    This question stems from a lecture. I feel both choices are important questions to ask but I feel that the first priority would be to ask the date and time of the last drink. Rational being that the client's greatest risk is injury from withdrawal symptoms. Early signs of withdrawal peak 24-48 hours after cessation.

    Thanks for the input. This has created some interesting conversation between classmates
    GrnTea likes this.
  6. Visit  Stephalump} profile page
    4
    I really don't like questions like that. In reality, I'm going to assess both of those things, both within 5 seconds of each other, and I, not going to use the information until I have the answer to both. It just seems nitpicky.

    I would think how often and how many times a week the pt drinks would be first priority. Then you'd know if there's any need to delve further into drinking habits. But you'd need to ask about other substances no matter what...so basically I just don't like the question
    Last edit by Stephalump on Feb 17, '13
    gummi bear, psu_213, Esme12, and 1 other like this.
  7. Visit  pinksapphire} profile page
    0
    I really don't like these questions either but it wasn't select all that apply. I totally agree with your answer but given only one choice which would it be?
  8. Visit  Stephalump} profile page
    1
    Eh, I guess I'd pick A, based on the fact that withdrawal usually happens within 12 hours of the last drink and it would impact how you medicate them.
    GrnTea likes this.
  9. Visit  emtb2rn} profile page
    1
    Quote from pinksapphire
    This question stems from a lecture. I feel both choices are important questions to ask but I feel that the first priority would be to ask the date and time of the last drink. Rational being that the client's greatest risk is injury from withdrawal symptoms. Early signs of withdrawal peak 24-48 hours after cessation.

    Thanks for the input. This has created some interesting conversation between classmates
    Yep, it's b. You wanna know when they had that last drink. Both answers are right but b is more right.
    Esme12 likes this.
  10. Visit  Stephalump} profile page
    4
    B, I mean. I'm very tired today, lol.
  11. Visit  hodgieRN} profile page
    2
    Although either one could be argued, I think B addresses the question. Many exam questions are like that. You have to answer what is being asked. The question is asking about alcohol withdraw, and answer B would tell you if they are withdrawing or not. If someone said they drank 4 hrs ago vs 2 days ago, then you will immediately know if the pt is actually withdrawing. Once you find out when they had their last drink and you are able to rule out withdraw, then you can move on to asking about other substances. Ruling out one of the differential diagnoses can change the entire course of how you treat. So, B is my opinion....
    gummi bear and Esme12 like this.
  12. Visit  bear14} profile page
    0
    I went back and forth a bit before I chose B. My teachers always say to look at the question and read word for word what they are asking and the answer is sometimes within the question. I've been tripped up on this many a times.
  13. Visit  mssjez} profile page
    1
    With this type of scenario, our instructors would say that you want to get as much info regarding the current topic (alcohol withdrawal) as you can before continuing on. Think about it this way... a patient comes into the ER with chest pain... are you going to ask them specifics about their chest pain first or move on and ask if they have pain anywhere else?
    Esme12 likes this.
  14. Visit  Esme12} profile page
    2
    I agree the question already states they are with alcohol withdrawal.....

    If someone walks up to you as a nurse with the shakes and tells you they are suffering fro ETOH withdrawl.....your first question is......when was you last drink .....how much do you usually drink, followed by..... do you use any other substances.
    Last edit by Esme12 on Feb 19, '13
    gummi bear and psu_213 like this.
  15. Visit  GrnTea} profile page
    0
    The NCLEX wants to know whether you recognize patient safety issues; they also want you to get more pertinent information to help you make decisions.

    If you have already assessed this person as showing signs of alcohol withdrawal, you know how dangerous this is if untreated. In order to protect him maximally, you need information on when his last alcohol intake was, so that's the priority.


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