Detoxing a patient

Daytonite, BSN, RN · Oct 29, 2007

What is it you are looking to know? I used to work on a detox unit that eventually became a very famous treatment center. You would recognize the name instantly if I mentioned it. Because we had detox beds we got any patient in the hospital who had a psychiatric diagnosis or who was having DTs.

BertinaRN, ASN, RN · Oct 29, 2007

I have cared for 3 pt with chronic alcoholism during my clinicals, and the coolest thing I ever learned was the tongue tremor. They can fake a shaking hand, but it is impossiable to fake a real tongue tremor, now that I know what a real one looks like I am aware about the coming DT's if I dont get those benzo's in them on time, and that they are not just med seekers.

VaPsychRN · Oct 29, 2007

I work on an acute psych & detox unit-- of my daily patient load of 4-7 patients, at least half are detoxing from alcohol, opiates, or benzos.

The biggest thing to keep in mind is that addicts/alcoholics have a legitimate illness that is beyond their personal control. That is what defines them as having an addiction. Perhaps a good place to start is the AA literature.

In terms of physical symptoms, there a lot of great resources out there. The main things to keep in mind-- alcoholics can and do die from withdrawal if not medicated properly (they die from seizures or DT'S). People in benzo withdrawal are at extremely high risk for seizures. Opiate withdrawal is not life threatening; however these tend to be the clients that have very poor tolerance to discomfort (hence, their addiction), so they can be very challenging if you don't understand and respect the pathology. Opiate withdrawal can be equated to having a bad case of the flu.

If you have prn meds from a doctor, give them liberally and if you don't have prn's, advocate for them! Also, they need fluids, vitamins (PO, IV, and/or balanced diet), falls precautions, seizure precautions, and a lot of EMPATHY from the nurse.

Hope this helps!

11202004 · Nov 2, 2007

I had a detox patient a couple weeks ago who was detoxing from alcohol and it was amazing to me the change in the patient's condition that occurred over night. When I left the hospital, the patient was acting pretty normal, but when I returned the next morning all heck had broken loose and the patient was a mess. It took us almost 300 mg of Valium to get the patient even slightly sedated and comfortable. I guess I wasn't expecting that, but then again, I didn't really know what to expect.