Alcoholism is considered the
modern drug because it is consumed in a legal way. Alcohol affects seriously
the personality and the consciousness of the consumer. Patients diagnosed as
alcoholic may be difficult to treat at an early stage of their illness because
of their unwillingness to accept the diagnosis or recognize that they have a
problem. Alcohol can produce all kinds of serious effects.
NURSING INTERVENTIONS:
¨ Monitor the vital
signs of the patient: Blood pressure, temperature, pulse and respirations.
¨ Give psychological
support to the patients and his/her family.
¨ Personal and
environmental hygiene is very important to avoid cross infections.
¨ Administer
medications prescribed by the doctor on time.
¨ Note time since
last ingestion of alcohol. Delirium tremens can occur up to seven days after
last alcohol intake.
¨ Assess for
signs/symptoms of hepatic encephalopathy.
¨ Note stage:
. Stage I :
Monitor mental aberrations, confusion.
. Stage II :
Asterixis, apraxia.
. Stage III :
Lethargy alternating with combativeness, stupor.
. Stage IV : Coma,
altered hepatic enzymes, altered liver function.
¨ Document
improvement/deterioration in level of encephalopathy.
¨ Monitor for
evidence of violent, hallucinatory, and/or delusional thought.
¨ Protect patients
from physical harm.
¨ Provide emotional
support by reassuring patient of physiologic cause of confusion.
¨ Assess resources,
ability to provide housing, food, medical care; alcoholic patients frequently
have difficulty holding steady jobs or may use money to buy alcohol instead of
food, medication and so on.
¨ Assess need for
readiness for alcohol rehabilitation.
¨ Teach the
following:
-Effect of alcohol
intake/abstinence; need for high calories, low-protein diet to facilitate
regeneration of damage liver cells.
-Signs and
symptoms of complications of cirrhosis: Abdominal pain, vomiting, anorexia,
loss of blood from GI tract, generalized bleeding (from gums, skin GU tract);
changes in level of consciousness .
¨ Teach dose,
administration schedule, expected actions, and possible side effects of
prescribed medications.
¨ Refer to alcohol
rehabilitation program if appropriate.