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Psychiatric Nursing 

CASE STUDY 3
 
A 43-year-old woman arrives on your unit. Her diagnosis is alcohol dependence disorder. She has been dependent on alcohol since she was 18 years old. During admission, she tells you she has been on a bender for the past 2 weeks. When she woke up, she drank four cans of beer and called it her breakfast. She tells you that she never feels normal unless she has her Wheaties every morning. She smiles and winks. Before noon, she finishes a six pack of beer. She then tells you that she and Johnnie Walker keep each other company for the rest of the day. You ask what time she goes to sleep, but she shrugs her shoulders saying she drinks until she blacks out. The patient reports being diagnosed with cirrhosis of the liver and esophageal varices last year. Her last drink was a few hours before she was admitted to the hospital. Her gait is steady. she speaks clearly and is alert X3, cooperative, and able to follow directions. Her BAl is 0.04. 
 
 
1. Why should the practitioner be concerned about the patient’s diagnosis of cirrhosis of the liver?
2. Why doesn’t the patient show signs of intoxication?
3. When would you place the patient under close observation? 
4. Why would a practitioner order thiamin and other B-complex vitamins and nutritional supplements for the patient?

SCIENCE
HEALTH SCIENCE
NURSING
NURSE 123

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