Author Question: A college student is brought unresponsive to the emergency department by friends, who say that their ... (Read 43 times)

altibaby · **on:** Jul 23, 2018

A college student is brought unresponsive to the emergency department by friends, who say that their friend drank more than half of a large bottle of whiskey 3 hours ago. Assessment reveals a blood alcohol level of 0.32.

The vital signs are BP, 88/32 mm Hg; R, 6/min; T, 96.8 F; and P,76/min and weak and thready. The nurse should prepare the patient for which intervention?
a. IV fluids and stimulants
b. Charcoal administration
c. Gastric lavage and dialysis
d. Naloxone (Narcan) administration

Question 2

A patient who is an active alcoholic is admitted to the hospital for surgery. The nurse reviewing orders for this patient would be correct to question which postoperative medication for this patient?

a. Acetaminophen
b. Diazepam
c. Morphine
d. Thiamine

meltdown117 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: C
The average rate at which a person can metabolize alcohol is about 15 mL (0.5 ounce) per hour. The patient in this scenario has consumed more than half of a large bottle of whiskey within 3 hours. Alcohol can be removed from the body by gastric lavage and dialysis. Gastric lavage washes out most of the alcohol if any is left in the gut, and dialysis is implemented to reduce the chance of renal failure and cardiovascular shock. Although intravenous fluids may be appropriate, stimulants are contraindicated for this patient. Charcoal is not indicated in this situation. Naloxone is indicated in opiate overdoses, not alcohol overdoses.

Answer to Question 2

ANS: A
Acetaminophen poses a risk of fatal liver damage in alcoholics, because evidence indicates that even modest alcohol consumption combined with acetaminophen has this effect. Diazepam would probably be useful in this case, because it is used to aid alcohol withdrawal. However, diazepam cannot be taken with alcohol, because the central nervous system (CNS) depressive effects would be compounded. Likewise, morphine is safe as long as it is not given with alcohol. Thiamine is a vitamin that often is deficient in alcoholics, so thiamine would be indicated.