ATI Real Life Clinical Scenario: Alcohol Use Disorder

Please answer the following questions:  Identify factors that increase the risk for alcohol use disorder. o Genetics / family hx o Chronic stress d/t socioeconomic factors o Hx of trauma, abuse, combat experience o Lower self esteem o Lower tolerance for pain and frustration o Few life success o Risk taking tendencies  Identify the diagnostic testing for a patient admitted as a result of a motorcycle accident who has alcohol intoxication. o X-ray or left arm o CT of head and neck o Toxicology screen for BAC  Identify interventions for the alcohol-abusing patient who has delirium tremens o Neuro assessment o Take vitals o Don’t leave the patient alone  Identify priority assessments for the newly admitted patient who had a motor vehicle accident (MVA) who has alcohol intoxication.

o CAGE questionnaire o Fall risk assessment o Braden Scale o Numeric pain scale o CIWA  Plan and prioritize evidence-based care for the patient in alcohol withdrawal who might develop delirium tremens. o Seizure precautions o Promote a low stimulation environment  Identify important nursing considerations for medications for alcohol withdrawal. What are those medications? o Lorazepam  Watch for respiratory depression and sedation  Only for acute use, not long term o Naltrexone  Can precipice withdrawal symptoms if the patient is not completely detoxified from alcohol o Topiramate  Monitor for oligohydrosis: take temperature and monitor for decreased sweating, closely monitor patient during exercise  Complete an accurate and effective SBAR communication tool.

o Medical conditions o Adverse effects of medications  Identify interventions for a patient who has anxiety. o Restating patients concerns o Remain with patient during the worst of the anxiety attack to provide reassurance o Perform a suicide risk assessment o Enhance self-esteem by encouraging positive statement and discussing past achievements o Assist the patient to identify defense mechanism that interfere with recovery  Identify priority assessments for the newly admitted patient who has anxiety o EKG o Chest X-ray o Blood specimen o Hamilton-A  Plan and prioritize evidence-based care for patients who have acute anxiety. o Relaxation techniques o Modeling o CBT o Systematic desensitization o Flooding o Response prevention

o Thought stopping  Identify important nursing considerations for medications used to treat anxiety. What are those medications? o Lorazepam  Watch for respiratory depression and sedation  Only for acute use, not long term o Escitalopram  Report changes in patient behavior because it could be associated with an increase of suicidal ideation  Complete an accurate and effective SBAR communication tool. o S: Simpson admitted to inpatient mental health unit for anxiety. She presents restless and fidgety, poor concentration and has chest pain and SOB o B: 22-yo African American Female with PMH of GAD. Previously taken paroxetine 20 mg Po daily but hasn’t taken it the past 2 weeks o A: VS: HR 115, BP 148/76, RR 32, SpO2 96% on RA, Temp 37. Hamilton A scale = 26. Unable to concentrate on answering questions d/t increased anxiety. Patient paces, wringing hands and rocks o R: requesting a prescription for lorazepam

ATI Real Life Clinical Scenario: Alcohol Use Disorder

Please answer the following questions:

Identify factors that increase the risk for alcohol use disorder.

oGenetics / family hx

oChronic stress d/t socioeconomic factors

oHx of trauma, abuse, combat experience

oLower self esteem

oLower tolerance for pain and frustration

oFew life success

oRisk taking tendencies

Identify the diagnostic testing for a patient admitted as a result of a motorcycle accident

who has alcohol intoxication.

oX-ray or left arm

oCT of head and neck

oToxicology screen for BAC

Identify interventions for the alcohol-abusing patient who has delirium tremens

oNeuro assessment

oTake vitals

oDon’t leave the patient alone

Identify priority assessments for the newly admitted patient who had a motor vehicle

accident (MVA) who has alcohol intoxication.

ATI Real Life Clinical Scenario-Alcohol Use Disorder and Anxiety

Management of Mental Health (NURSE 360)

University of Missouri-Kansas City

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