An alcohol-dependent patient was hospitalized at 4 AM on ...

[Charlie]

An alcohol-dependent patient was hospitalized at 4 AM on Saturday. The patient's last drink was at 2 AM. When would the nurse expect withdrawal symptoms to peak then disappear or progress to delirium?
 
  a. Between 8 AM and 10 AM Saturday
  b. Between 10 AM and 4 PM Saturday
  c. Between 4 PM Saturday and 4 AM Sunday
  d. Between 2 AM Sunday and 2 AM Monday

Question 2

You are a home health nurse completing the initial care plan for a patient with stage 3 Alzheimer's disease. Which data are essential to consider in creating the initial care plan? Select all that apply.
 
  a. Concerns, experiences and preferences of the caregiver(s)
  b. Patient's usual behavioral patterns, such as sleep and intake
  c. Patient's scores on standardized dementia assessment tools
  d. What expectations are realistic for this patient at this time?
  e. When the family/caregivers last had an opportunity for respite
  f. Knowledge and skill level of the patient's caregiver(s)

[bblaney]

Answer to Question 1

D
Alcohol withdrawal usually begins 6 to 8 hours after cessation or marked reduction of alcohol intake. It peaks between 24 and 48 hours, then resolves or progresses to delirium.

Answer to Question 2

A, B, D, F
The initial care plan should incorporate the experiences and preferences of the caregivers and the patient (to gain their support and avoid repeating approaches that have been unsuccessful or unimportant in the past). It should also build on and be consistent with the patient's usual patterns of behavior (where feasible). Another important element to include in planning care is what expectations might be realistic for a particular patient's circumstances, including the knowledge and skill levels of his caregiver(s). Although structured assessment rating scales can be useful, they are not necessarily critical for the initial care plan and may not provide as much practical guidance as the experiences of the patient's caregivers. Caregiver burnout is always a concern, so information about their coping status and access to respite is important but not usually essential for the initial care plan.

[Charlie]

Excellent

[bitingbit]

TYSM