Substance Abuse (Alcohol, Drug Withdrawal) for Progressive Care Certified Nurse (PCCN)
Included In This Lesson
Outline
Substance Abuse (Alcohol, Drug Withdrawal)
Definition/Etiology:
- Drug Withdrawal
- “Detox” outpatient or inpatient
- Depressants
- Stimulants
- Opioids
- Gradual (e.g. heroin)
- Methadone
- Bupronorphine (w. or w.o naloxone)
- “Detox” outpatient or inpatient
Pathophysiology:
- Alcohol withdrawal
- Can be more concerning
- Should be done with support
- *Focus*of this lesson
Noticing: Assessment & Recognizing Cues:
- Delirium Tremens “DTs”
- Shaking
- Hallucinations
- Seizure
- CIWA assessment
- Physical assessment
- Detox
- Starts hours to 5 days after
- Lasts 2 to 7 days
Interpreting: Analyzing & Planning:
- Consult psych
- Blood work
- Blood alcohol level
- Liver function tests
- Basic Metabolic Panel
- Magnesium
- Vitamin deficiency test
Responding: Patient Interventions & Taking Action:
- Medications
- Benzos
- Clonidine
- Carbamazepine
- Beta-blockers
- Antipsychotic meds
- Prenatal vitamin
- Physical support
- Gastritis
- GI bleeding
- Liver disease
- Cardiomyopathy
- Pancreatitis
- Vitamin deficiency (folate, thiamine)
- Electrolyte imbalance
Reflecting: Evaluating Patient Outcomes:
- DT’s limited or prevented
- In “Recovery” for life
- Continued support (e.g. AA)
Linchpins (Key Points):
- Assess DTs
- Benzos
- CIWA
- Prenatal vitamin
- Alcohol =ABC and P
Transcript
References
- Mayo Clinic. (2022a.). Diagnosis & treatment. Alcohol use disorder. https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/diagnosis-treatment/drc-20369250.
- Mayo Clinic. (2022c). Symptoms & causes. Alcohol use disorder. https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243.
- Saitz, R. (1998). Introduction to alcohol withdrawal. Alcohol Health Res Wordl, 22(1), 5-12.