Alcohol Withdrawal Case Study (45 min)
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Outline
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%
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?
What question needs to be asked in regard to the patient’s alcohol intake?
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.
What precautions does the nurse need to set up for this patient?
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.
When will this patient likely be no longer legally intoxicated? What is the implication of this time period?
What medications will the doctor likely order for this patient to replace vitamins?
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.
What medication could be ordered for this patient to help keep him sober?
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Nursing Case Studies
This nursing case study course is designed to help nursing students build critical thinking. Each case study was written by experienced nurses with first hand knowledge of the “real-world” disease process. To help you increase your nursing clinical judgement (critical thinking), each case study includes answers laid out by Blooms Taxonomy to help you see that you are progressing to clinical analysis.
We encourage you to read the case study and really through the “critical thinking checks” as this is where the real learning occurs. If you get tripped up by a specific question, no worries, just dig into an associated lesson on the topic and reinforce your understanding. In the end, that is what nursing case studies are all about – growing in your clinical judgement.
