A patient who has undergone treatment for alcoholism several ...

[arivle123]

A patient who has undergone treatment for alcoholism several times, with relapse occurring shortly after each treatment, has just completed detoxification. The patient requests a medication to help maintain abstinence.
 
  Which drug will the nurse expect the provider to prescribe?
  a. Acamprosate (Campral)
  b. Chlordiazepoxide (Librium)
  c. Disulfiram (Antabuse)
  d. Naltrexone (ReVia)

Question 2

A patient is brought to the emergency department after a motor vehicle accident. The patient's speech is slurred. The nurse notes the smell of alcohol on the patient's breath and observes hand tremors.
 
  The patient's blood alcohol level is 0.4. The nurse will expect to:
  a. find that the patient has lost consciousness within a short time.
  b. administer naltrexone (ReVia) and prepare for gastric lavage.
  c. give carbamazepine to reduce the risk of seizures.
  d. provide mechanical ventilation and oxygen.

[EAN94]

Answer to Question 1

ANS: D
Naltrexone helps reduce the craving for alcohol and blocks its reinforcing effects. It has been shown to be more effective than acamprosate, which acts by reducing the unpleasant feelings associated with abstinence. Chlordiazepoxide is used for detoxification to minimize acute effects associated with withdrawal. Disulfiram causes severe, uncomfortable, and sometimes life-threatening symptoms when alcohol is consumed and is not widely used.

Answer to Question 2

ANS: D
A blood alcohol level that exceeds 0.4 poses a substantial risk of respiratory depression. Patients who are chronic abusers of alcohol may develop tolerance to other effects of increased blood levels, such as sedation, or behavioral changes, but there is very little tolerance to respiratory depression. A patient with a blood alcohol level of 0.4 must be treated for respiratory depression, usually with mechanical ventilation. If this patient has developed tolerance, which is likely because loss of consciousness has not already occurred, the nurse cannot expect that the patient will lose consciousness. Naltrexone is not used for acute toxicity. Carbamazepine is used as an adjunct to benzodiazepines and may be used after this patient's immediate needs have been addressed.

[arivle123]

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[EAN94]

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