Andrew Davis
Age: 56 years
Diagnosis: Alcohol withdrawal syndrome
Score
2
1
0
85%
Feedback Log
0:00 Patient
0:00 You checked
... [Show More] scene safety. It was correct to check scene safety in order to maintain your own safety.
0:06 You introduced yourself.
0:43 You identified the patient.
You should have washed your hands as soon as you entered the room to maintain patient safety.
0:59 You asked if the patient had any known allergies.
1:16 You assessed the respiration.
1:29 You checked the radial pulse.
1:41 You checked the pulse oximetry.
1:58 You measured the blood pressure.
2:17 You measured the temperature.
3:54 You said: Alcohol withdrawal can cause a variety of symptoms, some of which can be dangerous to your overall health. I am going to ask you a series of questions to assess your current health status and your level of alcohol withdrawal symptoms. The assessment tool is called the Clinical Institute Withdrawal Assessment, or CIWA.
4:27 The patient said: Why are you asking me so many questions? You are making my headache worse.\nYou answered: I appreciate how difficult it is to answer so many questions; however, I need to complete an assessment of you today. \nYou used the therapeutic technique of giving information.
4:39 You said: Have you vomited? The patient said: No.
4:59 You observed the patient's sweat.
5:26 You said: Does the light hurt your eyes? The patient said: No.
5:38 You said: Have you had any numbness? The patient said: No.
5:44 You said: Have you had any itching? The patient said: No, I don't have any itching.
5:54 You said: Are you seeing anything that is disturbing to you? The patient said: No.
6:03 You said: Are you hearing anything that is disturbing to you? The patient said: No. Just all of these questions.
6:28 You asked the patient: Do you have any pain? The patient said: Yes, I have some pain.
6:36 You asked the patient: Where is your pain located?
6:49 The patient said: This headache, it won't go away!\nYou answered: A persistent headache is a common symptom of alcohol withdrawal. \nYou used the therapeutic technique of giving information.
6:52 You asked the patient: How would you rate your pain, on a scale of 0 to 10? The patient said: It's about a 4.
7:14 You said: What is today's date? The patient said: It is the 24th.
7:23 You said: Where are you? The patient said: Some sort of hospital facility.
7:35 You observed the appearance.
7:55 You assessed the speech.
8:01 You assessed the thought processes.
8:07 You observed the patient's agitation.
8:15 You observed the patient's tremors.
10:10 You completed the CIWA-Ar assessment tool. Some of your assessment answers were incorrect.Regarding the indicator "Paroxysmal sweats - Observation": You should have indicated "3," "4 beads of sweat obvious on forehead," or "5."Regarding the indicator "Auditory disturbances - Observation": You should have indicated "1 very mild harshness or ability to frighten," "2 mild harshness or ability to frighten," or "3 moderate harshness or ability to frighten."Regarding the indicator 'Visual disturbances - Observation' You should have indicated '2 mild sensitivity' or '3. moderate sensitivity'.\n\n
10:20 You observed the patient's tremors.
10:46 You asked the patient: Can you tell me a little bit more about what's going on with you today? It was appropriate to ask the patient what was going on with him to get an understanding of this.
11:02 The patient said: I can't think straight with everyone yelling.\nYou answered: Mr. Davis, there is no one yelling. Sensitivity to sound is a common symptom of alcohol withdrawal. \nYou used the therapeutic technique of presenting reality and giving information.
11:05 You asked the patient: Over the past year, when did you feel your best? It was appropriate to ask the patient about when he felt his best.
11:19 The patient said: Sometimes I wake up in the morning and I can't remember things. It's scary.\nYou answered: What are you concerned might happen? \nYou used the therapeutic technique of seeking clarification.
11:21 You asked if the patient had any known allergies.
11:27 You performed medication reconciliation.
11:46 You called the provider.
12:15 You administered diazepam. This is correct.
12:42 You educated about CIWA results.
13:17 You educated about discharge.
13:45 You educated about medications.
You should have educated about substance abuse.
14:34 You educated about short-term goals.
15:17 You educated about substance abuse.
Alcohol use disorder is a disease that carries social stigma. Students should clarify their own feelings and values related to individuals with substance use disorders, as well as their world view of alcohol. Experiences students may have had with friends or family with substance use disorder will affect these perceptions. They need to be aware of how this can impact caring for patients with this diagnosis.lt;/p>lt;p>Alcohol withdrawal has physical symptoms that begin 4 to 12 hours after cessation of alcohol intake. The symptoms can be mild (headache, tremor) to severe (hallucinations, delirium tremens, seizures). It is imperative that nurses recognize symptoms and provide early pharmacologic interventions.lt;/p>lt;p>Alcohol use disorder is a disease that requires treatment. It is important that nurses communicate in a nonjudgmental manner. Motivational interviewing is a good intervention with alcohol use disorder as it promotes a collaborative approach rather than a patriarchal/matriarchal approach to care. Nurses interface with patients at different levels of readiness to access treatment. Denial is a common defense mechanism, as is the cycle of abuse, remission, and relapse. The nurse needs to work with the patient to address consequences of actions without judgment.lt;/p>lt;p>Alcohol use disorder is marked by the dysfunctional use of alcohol. There is a biological basis to dysfunctional alcohol use that makes some patients more susceptible to having diminished self-control over use. The activation of the dopamine reward system is a primary source of addiction. This system is more intensely activated in patients with a vulnerability to addiction. This activation can be so overpowering that the alcohol becomes the priority in the patient’s life, to the exclusion of family, work, self-care, and often safety.lt;/p>lt;p>There is not a defined amount of alcohol that designates a diagnosis of alcohol use disorder. There are guidelines for low-risk use of alcohol: for men, this means 4 or fewer standard drinks on any single day and fewer than 14 drinks during any given week, and for women, this means 3 or fewer standard drinks on a single day and fewer than 7 drinks in a week. However, the diagnosis of substance use disorder is more focused on functional and relationship challenges secondary to the use of the substance, as well as cravings and difficulty stopping the use of the substance. Students need to be self-aware of frustrations and expectations in working with this population.lt;/p>
You got 85% [Show Less]