6 Blurry Street, Hazeville, NSW, 0050.
John Knott-Goode works full time in the building industry. After work he stops in at the local pub for a quick schooner with the boys, and then picks up a six pack of stubbies (full strength beer) to take home. At weekends there is sport on Saturday which involves more beer (3 long neck bottles, full strength), and on Sunday there is always the big family barbecue, where several casks are opened. One Friday night John falls down the back stairs at home and is sent to hospital where he finds he has a broken leg which will have to be surgically repaired.
1) What should be included in an “alcohol and other drug use” history for this patient? (Suggested word limit approximately 300 words)
When taking the drug and alcohol history we should not only focus on alcohol issues but also includes his personal and family history. While exploring his alcohol history most importantly his daily intake, pattern of alcohol, the amount consumed over the past week, if they have tried to reduce or quit before, if yes why did he try it and what was its outcome. (The University of Newcastle, 2010)
It is important to find out about the use of drug and alcohol and their reasons for it in order to discover if he has any unresolved psychological problems due to hostile life history or feelings of loneliness. It is important to know his attitudes towards his own drug or alcohol use and his response towards other people’s concerns or comments about his alcohol consumption. (Sacks, &Keks, 1998)
If he has a family history of alcohol or other drug problems, personal history of childhood abuse, violence or isolation from family and the community then he could be at risk. Therefore addressing John’s previous life history, family and social networks or support group, his consumption, frequency and duration of alcohol abuse are important informationfor health practitioners to provide more appropriate intervention and treatments to achieve his physical and well-being. (Sacks &Keks, 1998)
2) List the risk factors for withdrawal and potential symptoms that may occur with withdrawal from alcohol.
Withdrawal is often very painful, unpleasantand uncomfortable as their body, including their nervous system, is trying to overcome depressing effects of alcohol and settle in to the normal behaviour and an alcohol free bloodstream. Therefore patients suffering from withdrawal can range from mild to severe effects. It was found that alcohol withdrawal syndrome takes about six or twenty four hours to appearafter cessation of drinking or after last drink andin some dependent drinker by just lowering alcohol intake. (Elholm et al., 2011)
The initial symptoms of mild to moderate alcohol withdrawal often include dysphoria, insomnia, anxiety, restlessness, nightmares, sweats, tremor, irritability, nausea, agitation, tachycardia and hypertension whereas in severe cases it includes Delirium Tremens which generally occur between three to five days after stopping of drinking. It was further known that in extreme cases alcohol withdrawal can be life threatening and will need immediate medical assistance just like hallucinations, increased agitation, seizures, Wernicke’s encephalopathy, cardiac arrest and may lead to death.(Saitz, 1998)
3) What management strategies would you as a health professional plan and/or implement for John whilst he is in hospital withdrawing from alcohol? (Suggested word limit approximately 300 words)
John’s present medical situation, his history of alcohol intake and his alcohol withdrawal assessment can help determine the successful management strategies and have worthwhile outcome for him. Many factors like his motivation for withdrawal care, his goal, potential barriers that may impact on obtaining his goal, a post-withdrawal plan including relapse prevention, different support networks, his psychological needs and his close friends and...