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Alcohol Withdrawal Case Study (45 min)

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The patient is a 45-year-old male who is a “frequent flyer” in the emergency room for abdominal pain. The patient always has a high ETOH level and demands to be given 3 macaroni and cheese dishes, 2 chicken sandwiches and 2 whole milk cartons. Vital signs are as follows:

HR 103

RR 20

BP 125/67

Temp 98.6°F orally

SpO2 98%

Critical Thinking Check
Bloom's Taxonomy: Application

Given that he will be admitted to the hospital for a few days without access to alcohol, what protocol medication needs to be ordered for this patient?

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Critical Thinking Check
Bloom's Taxonomy: Application

What question needs to be asked in regard to the patient’s alcohol intake?

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The patient reports he drank 2 pints of liquor and a 6-pack of beer tonight.  The patient is telling the nurse that he is serious this time and is going to quit drinking for the holidays so that his family will let him come over for Christmas. The patient is slurring his speech and has a history of trying to elope from the hospital.

Critical Thinking Check
Bloom's Taxonomy: Application

What precautions does the nurse need to set up for this patient?

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The patient has an IV line, labs are drawn and the patient has their meal. The blood alcohol level comes back 395 mg/dL. The nurse knows that the patient will metabolize 100 mg/dL every four hours and that the patient is no longer legally intoxicated once it falls to less than 80 mg/dL.

Critical Thinking Check
Bloom's Taxonomy: Comprehension

When will this patient likely be no longer legally intoxicated? What is the implication of this time period?

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Critical Thinking Check
Bloom's Taxonomy: Analysis

What medications will the doctor likely order for this patient to replace vitamins?

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The patient has been in the hospital for 14 hours now and is no longer legally intoxicated. The vital signs have stabilized and the patient is alert and oriented x4. The patient remains hopeful to stop drinking and is asking for additional help to stay sober.

Critical Thinking Check
Bloom's Taxonomy: Application

What medication could be ordered for this patient to help keep him sober?

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Critical Thinking Check
Bloom's Taxonomy: Application

What education does this patient need in order to be successful on this medication?

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