NURSING CARE PREPARATION

Student Name: Diana Millan

Unit/Room Number: PSU 380
Age: 60
Gender: Male
Eriksons Developmental Level: Generativity vs.
Stagnation

Date of Care: 10/23/14

Date of Admission: 10/20/14
Ethnic/Cultural Preferences: Unknown
Allergies: NKDA
Code Status: Full Code

Primary Diagnosis:
ETOH withdrawal
Co-morbidities:
Hypertension

Discharge Plan (add day of clinical):

Pt is to be discharged to alcoholic rehab center. This will be following alcohol detoxification. The first step to
rehabilitation is accepting the problem. In this case, the patient does not realize a problem exists and minimizes
how much he drinks. If he does not accept he has a problem, rehabilitation will be impossible. The patient does
not have a family and lives alone. He has no one to talk to and would benefit from a support system and talking
to people that have gone through or are going through the same situation. On the other hand, nutrition is also a
problem. The patient must continue taking his supplements to prevent and/or correct deficiencies. Teaching
should include side effects/complications of alcohol use on body organs and effect on blood pressure. The
caregiver must work with the patient to find as many positives as possible in his life as well as positive
outcomes of decreased alcohol use or elimination.

Preliminary Integrated Pathophysiology primary diagnosis (what is going on with your client at the cellular
level for the health condition). Explain how your clients primary diagnosis, co-morbidities, medications and
labs interrelate. 1-3 page APA formatted.

Data Collection (Record exactly what is written on the personal information sheet [aka Kardex]. Any
assessment/elaboration should be made on the assessment sheet):
Diet (Type): Regular
IV (Fluid type, rate, access type): Lorazepam IV push
1mL PRN
I&O (MD order/Nursing Order/Frequency): End of
CBG (Yes/No, frequency): NO
shift
Fall Risk/Safety Precautions (Yes/No): Yes
Activity (What is the patient activity level): Encourage
ambulation; 1-2 person assist
Wound Care (Yes/No): NO
Oxygen (Yes/No, Delivery method, how much): NO
Drains (Yes/No, Type): NO
Other Tubes: N/A

Last BM: 10/23/14

ASSESSMENTS
(Include Subjective & Objective Data)
Integumentary:
Skin: Pink, warm, dry- occasionally diaphoretic
No tenting
Abrasion right knee; red, clean, dry intact, open to air
Face: flushing noted on cheeks
No itching of skin
Skin color appropriate for ethnicity
IV: right forearm 18ga
IV phlebitis and infiltration scale: 0
IV site: clean, dry, intact, no signs of swelling or
inflammation, no pain or tenderness
Braden score: 17 low risk
Eyes/Ear/Nose/Throat:
Ears, eyes, nose: symmetrical, no drainage or
discharge, no tenderness or pain
Vision deficit, uses reading glasses
Pupils: PEARRLA
No hearing deficit
No difficulty swallowing
Oral mucosa: pink, moist
Cough, non-productive

Cardiac:
Hx: HTN
S1, S2 present
Apical pulse: 106 bpm, regular rhythm; rate remained
tachycardic during shift
Radial pulses: strong, regular, equally bilateral
Capillary refill: 3 sec upper and lower extremities
Slight clubbing of fingernails
No JVD
No peripheral edema
BP: 120/85, 116/74
Genitourinary:
Continent, uses bedside commode
No burning, stinging, pain with urination
No genitourinary hx
Intake: 600 mL
Output: 400 mL
Neurological/Psychosocial
Awake, alert, oriented X2, occasionally X3
Cooperate
Responds appropriately but response is delayed
Speech is mumbled
Hand grips: stronger on right hand
Dorsi/plantar flexion stronger on right side
Poor coordination

Head and Neck:

Head: round, soft
No alopecia
Neck: no masses, pain, swelling, or tenderness on
palpation
Trachea: midline

Thorax/Lungs:
RR: Occasionally tachypneic 26, 24 breaths/min,
shallow
Symmetrical chest expansion, equal chest rise and fall
Lung sounds clear to auscultation
No reported dyspnea/SOB
Respirations increase during exertion and episodes of
anxiety
No accessory muscle use
No reports of pain with breathing
SaO2: 93-94% room air
Musculoskeletal:
No musculoskeletal hx
Stooped posture
Unsteady gait, poor equilibrium
Tremors, feet shuffling on ambulation
Decreased strength in lower extremities, pt has
difficulty standing/walking
Strength greater in right upper and right lower
extremity AEB grips and plantar/dorsiflexion

Gastrointestinal:
Abdomen: soft, no pain, tenderness on palpation
No diarrhea, Pt states he is a bit constipated
Last BM: 10/2314 2000
No distention
No nausea/vomiting
Other (Include vital signs, weight):
Height: 68 in
Weight: 65.7 kg
BP: 120/85, 116/74, sitting up left upper arm
P: 104-107, increased to 123 when anxious
RR: 20-26, shallow, regular rhythm
Temp oral: 98.1F, 98.5F
Pain (chronic or acute)

CIWA scores of 16 at 1800 & 1900, CIWA score of 6

at 2000
Tactile disturbance: mild to moderate Numbness,
tingling on body, especially arms and legs
Visual disturbance: mild; light appears too bright,
hurts/bothers pt
No hallucinations reported
No auditory disturbances
Moderate tremors with arms extended
Paroxysmal sweats 2-3 on scale of 0-7
Mild to moderate nervousness/anxiety
No headache, fullness in head
Pt visibly agitated at times, usually when effects of
Ativan wear off
Disoriented by no more than 2 calendar days, oriented
to person, place, sometimes time, disoriented to event

Pain management: No pain reported

CURRENT MEDICATIONS
List ALL regularly scheduled and prn medications scheduled on your client.
(Due morning of clinical)
Generic &
Trade Name

Classification

Dose/Route/
Rate if IV

Onset/Peak

Bifantis
(Align)

Probiotic

4mg=1cap
PO daily

Onset:
unknown
Peak:
unknown
Onset:
Unknown
Peak:
unknown
Onset:
Unknown
Peak: 30-60
min

Calcium
Carbonate
(Tums)
Cyanocobal
amin
(Vitamin
B12)
Folic Acid

Losartan
(Cozaar)

Magnesium
Oxide
(Mag-OX)
Nicotine

Fluid &
500 m=1 tab
electrolyte
PO BIDreplaceme
meals
nt; antacid
X2days
Supplemen 1000mcg=2
t Vitmain tab PO daily
B12

Supplemen
t vitamin
B9

1mg=1tab
PO daily
X3days

Angiotensi
50 mg= 1
n ll
tab PO QHS
receptor
antagonist;
antihyperte
nsive
Antacid; 400mg=1tab
saline
PO BID
cathartic
Smoking 21mg/24H 1
deterrent;
Patch
cholinergic Transdermal
receptor
daily

Intended
Action/Therapeutic
use. Why is this
client taking med?
GI
prophylaxis/bowel
care

Adverse
reactions (1
major side
effect)
Bloating

Nursing Implications for this client.

(No more than one)

Indigestion

Constipation

Note number and consistency of

stools, monitor serum calcium,
observe for S&S of hypocalcemia

Dietary supplement

Hypokalemia

Monitor potassium levels

Onset:
Unknown
Peak:
unknown
Onset:
unknown
Peak: 6 H

Dietary supplement

Reportedly
nontoxic

Obtain dietary history

HTN

Upper
respiratory
infection

Assess BP, do not give is SBP is less

than 90

Onset:
Peak:

Mg Supplement

Onset: rapid
Peak: 2-4H

Smoking cessation

Monitor Bowel movements

(diarrhea/constipation), Bowel sounds

Hypermagnesem Monitor for dehydration, hypokalemia,

ia
and hyponatremia, monitor Mg levels

Hypotension

Monitor BP

antagonist
Prenatal
Vitamin
w/Iron

Vitamin
supplemen
t

1mg=1tab
PO
daily/meal

Onset:
Dietary supplement
unknown
Peak:
unknown
Thiamine
Vitamin
500
Onset:
B1 replacement
(Vitamin
B1
mg=5tab PO
unknown
therapy
B1)
replaceme BID X2day
Peak:
nt
Unknown
Vitamin D Vitamin D
50000
Onset: 2-6H
Vitamin D
(Drisdol)
supplemen unit=1 cap
Peak: 10-12
deficiency
t
PO Q7days
H
Vitamin D Vitamin D 2000 unit=2 Onset: 2-6 H
Vitamin D
Cholecalcife supplemen tab PO daily Peak: 10-12
deficiency
rol
t
H
Diazepam
Benzodiaz 5 mg=1 tab Onset: 30-60
Anxiety &
(valium)
epine,
PO HS PRN
min
Insomnia
anticonvul
Peak: 1-2 H
sant,
antianxiety
Lorazepam Anxiolytic 2mg=2 tab
Onset:
Withdrawal
(Ativan)
; sedative
PO titrate
Unknown
symptoms
hypnotic;
PRN/
Peak: 2H
benzodiaze 2mg=1mL
pine
IV

Constipation

Monitor for constipation, nausea,

stomach upset, vomiting

Tightness of
throat

Record patients dietary history

Constipation

Monitor for S&S of hypercalcemia

Constipation

Monitor for S&S of hypercalcemia

Laryngospasm

Monitor signs and symptoms of

dizziness, sedation, drowsiness-risk
for falls

Sedation

Monitor signs and symptoms of

dizziness, hypotension, sedation,
drowsiness-risk for falls

DIAGNOSTIC TESTING
Include pertinent labs [ABGs, INRs, cultures, etc] & other diagnostic reports [X-rays, CT, MRI, U/S, etc.]
NOTE: Adult values indicated. If client is newborn or elder, normal value range may be different.
Date
Lab Test
Patient Values/
Interpretation as related to Pathophysiology cite
Normal Values
Date of care
reference & pg #
10/2 Sodium
137
2/14 135 145 mEq/L
Potassium
5.4
Electrolyte imbalance may be r/t alcoholism3.5 5.0 mEq/L
damaged cells causing release of K (muscle
break down)
Corbett, J. V., & Banks, A. D. (2013).
Laboratory tests and diagnostic
procedures: With nursing diagnoses (pp.
115-116). New Jersey: Pearson.
Chloride
105
97-107 mEq/L
Co2
23-29 mEq/L
Glucose
75 110 mg/dL
BUN
8-21 mg/dL
Creatinine
0.5 1.2 mg/dL

Uric Acid Plasma

4.4-7.6 mg/dL
Calcium
8.2-10.2 mg/dL
Phosphorus
2.5-4.5 mg/dL
Total Bilirubin
0.3-1.2 mg/dL

Total Protein
6.0-8.0 gm/dL
Albumin
3.4-4.8gm/dL
Cholesterol
<200-240 mg/dL
Alk Phos
25-142 IU/L
SGOT or AST
10 48 IU/L
LDH
70-185 IU/L
CPK
38-174 IU/L
WBC
4.5 11.0
RBC
male: 4.7-5.14 x 10

27
105
8
0.41

May be r/t to muscle breakdown (muscle tissue

atrophy) as result of long term alcohol abuse
Corbett, J. V., & Banks, A. D. (2013).
Laboratory tests and diagnostic
procedures: With nursing diagnoses (pp.
90). New Jersey: Pearson.

9.9

1.5

May be r/t alcohol use causing inflammation of

liver leading to obstruction of bile ducts or may
be r/t destruction of RBCs
Corbett, J. V., & Banks, A. D. (2013).
Laboratory tests and diagnostic
procedures: With nursing diagnoses (pp.
261-263). New Jersey: Pearson.

7.3
4.0

62
46

7.8
4.12

May be r/t to malnutrition (anemia), iron and

female: 4.2-4.87 x 10

folic acid deficiency

Corbett, J. V., & Banks, A. D. (2013).
Laboratory tests and diagnostic
procedures: With nursing diagnoses (pp.
26). New Jersey: Pearson.

HGB
male: 12.6-17.4 g/dL
female: 11.7-16.1 g/dL
HCT
male: 43-49%
female: 38-44%
MCV
85-95 fL

14.9

MCH
28 32 Pg

36.2

MCHC
33-35 g/dL
RDW
11.6-14.8%
Platelet
150-450
Other:

34.1

43.8
106

May be r/t folic acid deficiency- excessive

alcohol consumption
Corbett, J. V., & Banks, A. D. (2013).
Laboratory tests and diagnostic
procedures: With nursing diagnoses (pp.
34). New Jersey: Pearson.
May be r/t vitamin B12, folic acid deficiency
(Macrocytic anemia)
Corbett, J. V., & Banks, A. D. (2013).
Laboratory tests and diagnostic
procedures: With nursing diagnoses (pp.
35). New Jersey: Pearson.

13.3
134

DIAGNOSTIC TESTING
Date

UA

10/20/14 Color/Appearance

pH
Spec Gravity
Protein
Glucose
Ketones

Blood

Normal
Range

Results

Light
yellow to
dark
amber
5-9
1.10101.020
Neg
Neg
Neg

Light yellow,
clear

Neg

Neg

Interpretation as related to
Pathophysiology cite reference & pg
#

8.0
1.008
Neg
Neg
Trace

May be r/t malnutrition/starvation-body using fats as source of energy

Corbett, J. V., & Banks, A. D. (2013).
Laboratory tests and
diagnostic procedures: With
nursing diagnoses (pp. 72).
New Jersey: Pearson.

Date

Other
(PT, PTT, INR,
ABGs, Cultures,
etc)

Normal
Range

Results

Date
Radiology
10/20

X-Rays Chest

10/20

Scans CT Head

Results

Interpretation as related to
Pathophysiology cite reference & pg
#

Interpretation as related to
Pathophysiology cite reference & pg
#

Calcification in thoracic aortic

arch. Heart within normal
limits of size. No infiltrate or
effusion
Ventricles and sulci are slightly
prominent, no shift of midline
structures or other mass effect;
minimal atrophy

EKG-12 lead
Telemetry
Other

DAR NURSING PROGRESS NOTE

Include the same note that was written in the client record for the priority nursing diagnostic statement.
Include the date/time/signature.

Pt awake, alert, oriented X3. Pt denies pain. States he feels disoriented, anxious. Took pt for a walk in the hall
along with CNA. Walked about 35 feet. Sat down in bed, watching TV. Pt appears calm, less anxious. Bed in
lowest position, personal items within reach, 1:1 sitter in room. 10/23/14 @ 1700---------------------------------------------------------------------------------------------------------------------------------------D. Millan, SN
Performed CIWA assessment. Score of 16. BP 120/85, pulse 106, RR 26. Administered Ativan 2mg per CIWA
protocol. Pt resting, watching tv. Bed in lowest position. CNA in room. 10/23/14 @ 1800------------------------------------------------------------------------------------------------------------------------------D. Millan, SN
Performed CIWA assessment. Score of 16. BP 116/74, pulse 105, RR 24. Administered Ativan 2 mg per CIWA
protocol. Pt. sitting up in bed, watching TV. Bed in lowest position. CNA in room. 10/23/14 @ 1900-----------------------------------------------------------------------------------------------------------------D. Millan, SN
Pt was tired/sleepy during CIWA assessment- 1hour post CIWA score of 16. Had to wake pt up several times
to ask CIWA questions. He appears calm and not anxious. Bp 120/85, pulse 106, respirations are a bit shallow,
O2 sat drops down to 88% room air. Brenda, RN applied oxygen N/C @ 2Lpm and raised O2 sat to 96%. Pt
sleeping, Bed in lowest position. 1:1 sitter in room. 10/23/14 @ 2000-------------------------------------------------------------------------------------------------------------------------------------------------------D. Millan, SN

PATIENT CARE PLAN

Patient Information:
60 year old male
Admitting diagnosis: Alcohol withdrawal
Allergies: NKDA
Code status: Full Code
Nursing Diagnosis should include Nanda Nursing Diagnostic statement, related to (R/T), as evidenced by
(AEB).
Problem #1 Imbalanced nutrition: less than body requirements r/t chemical dependence (alcohol) AEB
decreased dietary intake of vitamin D, B1, B12, folic acid, thiamine )
Desired Outcome: Pt will verbalize foods/meals rich in necessary vitamins for a balanced nutrition by end of
shift
Nursing Interventions
Client Response to Intervention
1.
1.
Assess willingness to learn and make lifestyle changes,
Pt does not realize he has a problem with
assess knowledge level regarding nutrition
drinking or nutrition
2.
2.
Teach patient regarding nutritional meals while considering Pt aware of nutritional meals, states his food
pt. food preferences
preferences include vegetables, fruits, fish,
occasional fast food; does not realize nutrition is
affected
3.
3.
Monitor lab values indicating nutritional well-being
Potassium, albumin are within normal values,
(potassium, RBC, albumin), obtain weight
RBCs are decreased
Evaluation (evaluate goal & interventions, what worked/what didnt, what would you adapt if needed):
Though patient is able to verbalize nutritional foods, he does not realize he has a problem with alcohol,
therefore does not believe his nutrition is imbalanced or requires correction as a result of alcohol use. RBC is
decreasing indicating possible anemia resulting from vitamin deficiencies, specifically B vitamins. Though the
outcome was met, the benefit is small since the patient does not believe his nutrition is affected by alcohol use.
Problem #2 Anxiety r/t alcohol cessation/physiologic withdrawal AEB increased tension and irritability
Desired Outcome: Pt. will verbalize strategies to decrease anxiety by end of shift
Nursing Interventions
Client Response to Intervention
1.
1.
Assess pt.s level of anxiety & perceived cause
Pt experiencing moderate anxiety, does not
understand/know why
2.
2.
Teach pt anxiety reducing strategies (breathing,
Pt distracts himself watching TV (sports), going
visualization, positive self-talk)
for walks helps reduce anxiety
3.
3.
Administer benzodiazepine PRN; Provide support,
Anxiety/nervousness reduced with lorazepam;
reassurance, acceptance and encouragement
allowing patient enough time to express himself
prevents increased anxiety
Evaluation:
Going for walks outside his room helps the patient decrease anxiety. He feels most nervous when he cannot go
out to the hall due to unsteady gait. The patient probably feels trapped in his room. Though he does not
understand the cause of his nervousness, he does know what helps him feel calmer. The patient would benefit
from someone to just talk to and serve not only as a distraction but as a support person since he does not have a
family. He should continue using his strategies for reducing anxiety such as going for a walk and resting
afterwards.

Problem #3 Risk for injury r/t alcohol cessation AEB equilibrium/balancing difficulties, reduced coordination
and recent fall
Desired Outcome: Pt will not experience physical injury during shift
Nursing Interventions
Client Response to Intervention
1.
1.
Assess coordination, gait and balance, mental status
Poor coordination, unsteady gain, pt is alert
though not fully oriented
2.
2.
Instruct patient to use call light when getting up/walking;
Pt had 1:1 sitter; did not use call light.
assist with ambulation and self-care activities PRN
3.
3.
Ensure safe surrounding environment (adequate lighting,
No falls, injury during shift
call light, path free of clutter, non-slip footwear)
Evaluation:
Pt was not injured in any way during shift. His coordination and gate are very poor. At times he is unable to
stand without serious risk of falling. He can be very unsteady upon walking. I think a CNA in the room 24hrs a
day is appropriate for safety reasons but the patient should still be given options and allowed some control. The
call button should still be with the patient and not with the CNA. Allowing the patient those types of options
allows him to not feel so trapped and anxious.

Running head: ALCOHOL WITHDRAWAL

Alcohol Withdrawal
Diana Millan
Southwestern Oregon Community College
10/23/14

ALCOHOL WITHDRAWAL

Alcohol Withdrawal
Sixty year old male was initially admitted to the emergency department where he was
brought by coworkers who were concerned about the patients alcoholism. The patient drinks
whiskey on a daily basis. He has now been admitted for three days and has very unsteady gait.
He had a fall Wednesday afternoon. According to a physicians note, he feels depressed and
drinks out of boredom. The patient does not have any family. He has a history of hypertension
and smoking (20 cigarettes/day) and may currently be showing signs and symptoms of Wernicke
Syndrome.
Effects of alcohol vary by age, gender, and percent of body fat. Disorders of the liver and
nutrition are consequences of alcohol abuse. Nutritional disorders include deficiencies in
magnesium, folic acid, vitamin B6, and thiamine (Huether & McCance, 2012). Folate, important
for the production and maintenance of new cells is inadequate due to decreased intestinal
absorption and increased urinary and fecal excretion (Huether & McCance, 2012). A deficiency
in folate also leads to decreased absorption of other nutrients and accelerates liver damage
(Huether & McCance, 2012). Alcohol also promotes the loss of vitamin B6, important for the
proper functioning of the immune and nervous system due to its involvement in the formation of
neurotransmitters (RecoveryCorps, 2014). Magnesium is reduced due to its loss from the
gastrointestinal system and reduced dietary intake. A deficiency in magnesium, as well as iron
contribute to symptoms of confusion, depression, insomnia, weakness and loss of appetite
(Boulder Medical Center, 2014). One of the most important deficiencies seen in alcoholism is
probably thiamine (vitamin B1). Thiamine is important for carbohydrate metabolism, the proper
functioning of neurotransmitters, and is involved in protecting neurons from injury (Perkins,
2013). A deficiency in this vitamin is strongly linked to alcohol induced dementia (Perkins,

ALCOHOL WITHDRAWAL

2013). It may also cause Beriberi, leading to lesions of nerves, general debility, and painful
rigidity (RecoveryCorps, 2014). As mentioned earlier, the physician believes the patient may be
showing symptoms of Wernicke syndrome. This syndrome is due to thiamine deficiency and is
often grouped together as one syndrome with Korsakoff syndrome. In Wernicke syndrome, also
referred to as encephalopathy, there is persistent learning and memory deficits, confusion, ataxia,
and nystagmus (Xiong, 2014). This is usually an acute confusional state and is reversible, though
may progress to Korsakoff syndrome in which there is irreversible dementia (Xiong, 2014). The
most severe form of alcohol withdrawal is delirium tremens (DTs). This is manifested by altered
mental status and autonomic hyperactivity, which can progress to cardiovascular collapse and
respiratory depression. (Burns, 2014) There is a loss of gamma-aminobutyric acid-A (GABA-A)
receptor stimulation which causes a reduction of chloride ion influx (Burns, 2014). The loss of
GABA-A receptor is associated with tremors, diaphoresis, tachycardia, anxiety, and seizures
seen in withdrawal (Burns, 2014). The lack of inhibition of N-methyl-D-aspartate, a type of
glutamate receptor can also lead to seizures and delirium (Burns, 2014).
Chronic alcohol consumption disrupts the sympathetic nervous system and causes the
release of stress hormones that lead to vasoconstriction and may directly affect smooth muscles
and their ability to dilate (Medscape, 2014). Magnesium depletion also causes a rise in blood
pressure, as does acetaldehyde, a product of alcohol metabolism (Medscape, 2014). If the patient
already had hypertension before alcohol use, then alcohol will significantly elevate his blood
pressure even more and will have difficulty maintaining it under control. Alcohol effects on
mental status can also contribute to the patient not taking or not wanting to take
antihypertensives. Alcohol could also be the initial cause of his hypertension depending on how

ALCOHOL WITHDRAWAL

long he has been drinking and how much. The patient is also a smokes cigarettes which will
cause the release of catecholamines and lead to additional vasoconstriction.
Serum potassium is increased and creatinine is decreased. These abnormal lab values are
consistent with muscle breakdown and atrophy as a result of chronic alcohol use. Potassium must
be monitored closely and its continued rise should be prevented or the patient may be at risk for
cardiac arrhythmias. Red blood cells are decreased which may be a result of vitamin deficiencies
common in alcoholism. There may be a destruction in red blood cells causing the increase in
bilirubin. The majority of medications for this patient involve vitamins to correct nutritional
deficiencies such as folic acid, vitamin D, B1, B12 and magnesium is also being administered to
correct magnesium deficiency seen in alcohol withdrawal.
At the beginning of shift, the patient was awake, alert and oriented to person, place, and
somewhat time. He knew the month and year but the day was off by two days which could be
from alcohol withdrawal or just forgetting like a lot of people do. He was disoriented to event.
He knew he was in the hospital but was not sure why. He later became anxious and wanted to go
for a walk. The CNA and I assisted the patient with ambulating down the hall and back. He was
less agitated after the walk. Upon two consecutive CIWA assessments, the patient scored 16 and
was administered Ativan per the protocol. On the third CIWA assessment, the patient scored a 6.
He had been sleeping at the time and appeared calm when answering questions. The patient has
been having tachycardia with occasional tachypnea during the shift. His respirations are shallow
and oxygen saturation dropped to the 80s on room air. He appears to need oxygen to maintain
SaO2 at 96% at the most. He works as a city planner and states he likes his job. When asked if it
was stressful, he stated sometimes. When asked how he deals with stressful events, he stated
one by one. He goes for walks or takes a couple drinks occasionally. He seems completely

ALCOHOL WITHDRAWAL

unaware of his drinking problem. He may need detoxification and rehabilitation but this will all
be easier if he has the support and encouragement of friends and coworkers as well as a strong
motivation.

ALCOHOL WITHDRAWAL

References

Boulder Medical Center . (2014). Nutrition recommendations for those who consume alcohol.
Retrieved from Boulder Medical Center :
https://www.bouldermedicalcenter.com/articles/Alcohol_Nutrition.htm
Burns, M. J. (2014, August 22). Delirium tremens (DTs). Retrieved from Medscape:
http://emedicine.medscape.com/article/166032-overview#aw2aab6b2b4aa
Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (5th ed.). St. Louis,
MO: Mosby/Elsevier.
Medscape. (2014). Alcohol consupmtion and hypertension . Retrieved from Medscape
Multispecialty: http://www.medscape.com/viewarticle/403751_4
Perkins, D. (2013, August 16). Thiamine & alcoholism. Retrieved from LiveStrong:
http://www.livestrong.com/article/285627-thiamine-alcoholism/
RecoveryCorps. (2014). Alcoholism and vitamin deficiency . Retrieved from Recover Programs
& Treatment Centers : http://www.recoverycorps.org/addiction/alcoholism/vitamindeficiency/
Xiong, G. L. (2014, October 15). Wernicke-Korsakoff syndrome . Retrieved from Medscape :
http://emedicine.medscape.com/article/288379-overview#aw2aab6b2b5

ALCOHOL WITHDRAWAL