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.
¨ 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.