Alcoholism or alcohol abuse

Need to know more about alcoholism? Want to know more about alcoholism? worry no more, here is a summary on Alcoholism or alcohol abuse. here are nursing intervention and case presentation of alcoholism, hope it helps.!

Addiction- is a term used to define a state of chronic or recurrent drug intoxication and is characterize by psychological and physical independence as well as tolerance.
Tolerance- occurs as the individual drinks more with less effect
Withdrawal occurs when an individual abruptly stops drinking after alcohol has become a necessity of life to maintain functioning.
Action of Alcohol
-CNS depressants
-loss of inhibition
-relaxation
- rapidly goes into the bloodstream
Overdosage of alcohol
-vomiting
-unconscious
-respiratory depression
Concept of Alcoholism as a disease
Alcohol is known to shorten an individual’s life span by 12 to 15 years unless treatment is received \. Like other chronic illnesses, it has certain observable symptoms.
Alcoholism
- -intoxication between 15-17
- Phases
- Pre-alcoholic- start for the reason of curiosity
- Early alcoholic – every weekend
- Sexually aggressive
- Lack of coordination
Physiologic effects of alcoholism
-gastro intestinal complications
-gastritis, pancreatitis, hepatitis, cirrhosis of the liver, esophageal varices, hemorrhoids, ascites.
-cardiovascular
- hypertension, weakened heart muscles and heart failure, broken blood vessel in the upper check and bloodshot eyes are common
-respiratory tract complications
- prostatitis, interference with voiding, release of sexual inhibition, fetal alcoholism syndrome,
-central nervous system
-depression, resulting in peripheral neuropathy, interference with nerve conduction, gate changes, and nerve palsies, occurs frequently.
-general appearance
-poor nutritional status, deficiency in vitamin A, D, and K, anemia, an increase susceptibility to infection , bruising and bleeding tendency.

Signs and symptoms
-impaired judgement, orientation memory, affect and cognition; impaired speech; behavioral changes and impaired mobility.
Three screening test
- Michigan alcohol screening test (MAST)
- CAGE screening test for alcoholism
- Alcohol use disorders identification test (AUDIT)
- -Blood and urine screening
- Brief drug abuse screening
Two categories of Alcohol related disorders
Alcohol use disorders
-alcohol dependence -3 or more of the 7 symptoms for 12 months
-tolerance withdrawal symptoms, intake alcohol in a larger amount. Persistent desire

-alcohol abuse- do not include tolerance and withdrawal , but has 1 or more symptoms
- recurrent drinking of alcohol due to failure or depression
-continue use despite of persistent

Alcohol induced DISORDERS
- 1.Alcohol intoxication – occurs after a recent ingestion of alcohol and is evidenced by behavioral changes such as impaired social or occupational functioning, fighting or impaired judgment.
S/s
- Modd changes increase verbalization, impaired attention span, irritability, slurred speech, lack of coordination, unsteady gait, impaired memory and stupor or coma.
2. alcohol withdrawal- clients generally experience clinical symptoms of alcohol withdrawal within several hours to a few days after the cessation or reduction of heavily or prolonged alcohol consumption,.
s/s
autonomic hyper activity, increase hand tremor, sleep disturbances, insomnia, nightmares , nausea or vomiting, trancient visual, tactile or auditory hallucinations or illusions, psychomotor agitation, anxiety and grand mal seizures, elevated temperatures in excess of 100*F and pulse in excess of 100 BP, may indicate impeding deliriums tremens
3. alcohol withdrawal delirium.
- delirium may occur 24 to 72 hours after the clients last drink.
s/s
elevation of v/s, accompanies restlessness, tremulousness, agitation and hyper alertness, any nose or quick movements are perceive as greatly exaggerated, shadows are misinterpreted, and illusions and hallucinations frequently occurs, the clients speech is incoherent.
4. alcohol induced persisting dementia
-individuals who experience a prolong, chronic, dependence on alcohol amy develop alcoholic dementia
s/s
severe loss of intellectual ability that interferes with social or occupational functioning and impaired memory, judgment, an abstract thinking. Permanent brain damage and occur in sever cases.
5. alcohol induced persisting amneistic disorder
- individuals who drink large amount of alcohol in a long period of time
2 CNS disorders associated
-korsakoffs psychosis – deficiency in vitamin B12 and thiamine
s/s
disorientation and confabulation
-wernickes encephalopathy- inflammatory hemorrhage degenerative
s/s diplopia and double vision

pharmacologic intervention
*disulfiram (antabuse) interferes with the breakdown of alcohol-
Client having serious heart disease, diabetes, epilepsy, liver impairment or mental illness is contraindicated
client must not have ingested alcohol for at leat 12 hours to prevent toxic reaction such as sever nausea and vomiting, hypotension headaches.
*Naltrexone (revia) treat alcoholism because it reduce client’s cravings for alcohol.
Contraindicated in patients with hepatitis or liver failure.
*thiamine – prevent or treat wernicke encephalopathy and Korsakoff.
*lorazepam (ativan) – for alcohol withdrawal syndrome.
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NURSING ACTIONS
- Provide safety for clients as they may exhibit clinical symptoms of overdose, intoxication or withdrawal
- Encourage client for therapy
- Encourage client to join in alcoholism support groups
- Seizure precautions can minimize chances of injury
- Intravenous barbiturates may be required to control extreme agitation
- Provide a safe environment for self-abusive or suicidal clients.
- Arrange dietary consultation with input by client
- STABILIZING MEDICAL CONDITION, STABILZING BEHAVIOR. MEDICAL MANAGEMENT,