Assessment for alcohol withdrawal

[pinksapphire]

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

[hodgieRN]

Is this homework? Tell us what you think about the answers.....

[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

[Stephalump]

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 :)

[pinksapphire]

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?

[Stephalump]

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.

[emtb2rn, BSN, RN, EMT-B]

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.

[Stephalump]

B, I mean. I'm very tired today, lol.

[hodgieRN]

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....

[bear14]

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.

[mssjez]

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, ASN, BSN, RN]

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.