NRS 308 NCLEX- Uworld _LATEST,100% CORRECT

Abuse (Alcoholism) • Every psych patient is first and foremost a med-surg client • Perform med-surg eval before psych eval • All intoxicated clients should be given IV thiamine before (or with) IV glucose to prevent Wernicke encephalopathy Psychological Problems • #1 Denial (anger, bargaining, depression, loss) o Alcoholism – confront and try to stop o Grief and Loss – support and allow to continue • #2 Dependency/Co-dependency o Nature of act is harmless o Dependent – Has time to focus on abuse o Co-dependent – Derives positive self-esteem by doing things for the abuser o Treatment ▪ Set limits and enforce them ▪ Decide ahead of time which requests are reasonable and which are not and then enforce agreements ▪ Self-esteem needs of co-dependent must come from within • #3 Manipulation o Nature of act is harmful o Abuser gets significant other to do things for him/her that are not in his/her best interest o Treatment - set limits and enforce them Wernicke-Korsakof (Alcoholics) • Irreversible • Psychosis due to brain damage • Induced by vitamin B1 (thiamine deficiency), which is necessary for alcohol metabolism to occur • Primary symptom - amnesia with confabulation Aniverse Revia Disulfiram • Alcohol aversion therapy • Onset – 2 weeks • Duration – 2 weeks • Teach patient to avoid all forms of alcohol: o Insect repellants o Aftershave o Mouthwash o Elixirs (Benadryl, Robitussin)