Case Study M.C., a 45-year old Native

Case Study M.C., a 45-year old Native American male client is brought to the treatment center by his wife. The wife states that if M.C. leaves she will get a court order to keep him there. What criteria have to be met to keep a patient in treatment against their wishes? On arrival at 0200, M.C.s blood alcohol level is 0.24 or three times the legal limit. He reports that he was sober for six months last year, which was after his inpatient treatment for alcohol abuse. He has been drinking daily for the past six months. M.C. reports, “I went out and got drunk after I found my wife with her college instructor. She says I’m a bore since I stopped drinking and she wanted a divorce. I felt devastated, so I started drinking again. She was the one who wanted me to quit in the first place. I don’t know what I’m going to do. I can’t take it anymore.” Assessment Using therapeutic communication, how would you reply to this client? What other statement should you for the client’s safety? How does the Native American Culture view alcohol dependence and addiction in regards to prevention, supportive interventions, and professional treatment? What societal stereotypes, stigma, and myths should you take into consideration in suggesting culturally sensitive treatment plans? CIWA-Ar Assessment tool is used to measure alcohol withdrawal symptoms. When should the nurse anticipate the start of alcohol withdrawal syndrome? What are the signs and symptoms measured by this tool? Diagnosis List two culturally sensitive three-part nursing diagnoses that would apply to this case study. One should address safety needs. Write two goals for this patient. Goals should be specific, measurable, attainable, realistic, and timed. Implementation: Here are medications given during alcohol withdrawal, used for treatment of alcoholism. When should benzodiazepines be started? Why is thiamine used? Evaluation After your client has successfully finished the withdrawal process, he refuses inpatient treatment. He states that he will go to Alcoholics Anonymous meetings on his reservation. He agrees to take antabuse for 2 months after he leaves treatment. What teaching does he need regarding this medication? SCIENCE HEALTH SCIENCE NURSING NU 242

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