Case Study: Addiction Read the case study below and answer the following questions: You are the nurse assigned to care for Mike a 45-year-old man who was just admitted for alcoh

Case Study: Addiction

Read the case study below and answer the following questions:

You are the nurse assigned to care for Mike a 45-year-old man who was just admitted for alcohol intoxication. On initial assessment you note Mike’s VS are Temp 102.2° F, BP 174/98, HR 110, RR 24. O2 sat 98% RA.  He has a slight tremor in his hands, is diaphoretic, and appears anxious.  He reports a headache and appears flushed. In response to your questions Mike denies he has an alcohol problem but later on admits to drinking approximately a fifth of vodka daily for the past 2 months, and sometimes waking up and in the morning and not remembering what happened the night before.  He admits to having seizures while withdrawing from alcohol in the past.  He tells you that he “just can’t help it” and has strong urges to drink, but that he never means “to drink very much.” He has had trouble keeping a job over the past several months.

Questions:

1. What is the most likely time frame for someone to have withdrawal symptoms after abrupt cessation of alcohol?

2. You believe Mike may be demonstrating behaviors of alcohol use disorder.

A. List the symptoms a health care provider will consider to establish a diagnosis of alcohol use disorder.

B. Which of these symptoms is Mike is displaying?

3. What would be helpful for Mike’s physician to know regarding his substance use history?

4. Why is it important medically to identify patients who may be going through acute alcohol withdrawal while receiving medical and nursing care?

5. Explain why each of the following medications may be prescribed for patients experiencing acute alcohol withdrawal.

A. Thiamine (Vitamin B)

B. Beta Blockers

C. Benzodiazepines

D. Antiepileptic drugs, such as carbamazepine

6. Mike experiences alcohol withdrawal delirium that lasts for 36 hours before subsiding. He did not experience any seizures this time. His condition has stabilized and he is ready for discharge.  He tells you that he is “ready to go home” and does not want to “touch another drink” but admits that he needs help.

What medications might be prescribed to Mike to assist him with sobriety?

DisulfiramNaltrexoneAcamprosateNaloxoneBupropion

7. Mike is referred to the local AA program. What strategy can be implemented to increase his likelihood of attendance at these meetings?

8. Behavioral Therapy is used as a treatment method for alcohol abuse. Explain how this type of therapy benefits the client. 

9. Mike’s AA sponsor met with him while he was still in the hospital, and the meeting went well. The day after his discharge from the hospital, Mike attends his first AA meeting with his sponsor.

AA stand for Alcoholics Anonymous.