Tuesday, September 10, 2019

Alcohol abuse and alcohol disorders Case Study Example | Topics and Well Written Essays - 2000 words

Alcohol abuse and alcohol disorders - Case Study Example Consequently, the nursing care would need to be tailored as appropriate to help the client in such situations. In this assignment, the case scenario of a patient who has been admitted to the surgical area for a cholecystectomy for gallbladder stones will be discussed in that light. This patient is a 45-year-old male with cholelithiasis and cholecystolithiasis with mild hyperbilirubinaemia due to partial obstruction of the common bile duct due to stone. This patient is a known alcoholic, and the idea of admitting him to the hospital is to control his bilirubin levels and sustain his abstinence from alcohol in the hospital ward so the surgery becomes uneventful. Therefore, the nursing management plan will have to be designed which would take care of his problems during the course of his hospital management. The most important health issues during this preparatory phase of the management will be the nutritional care of the patient who has already been compromised from the nutritional po int of view. Literature has delineated the nutritional problems in alcoholics that arise from alcoholic hepatitis and pancreatitis. Moreover, alcohol per se leads to deficiency of vitamins due to poor nutritional intake and compromise in the fat digestion due to abnormal fat metabolism due to pancreatitis. Surgery is a stress situation (Breslow et al., 2006, 359-366). Therefore, for the upcoming surgery, this patient needs to be prepared nutritionally to be able to tolerate this stress. This problem has been compounded by the hyperbilirubinaemia on presentation that tends to aggravate these problems further. Alcoholic hepatic dysfunction and fatty liver both add to the gravity of the problem. From that perspective, one of the core issues would be nursing nutritional management of this patient. The second core issue is related to his habitual alcohol intake that is continuing over years. A sudden stop or abstinence forced or otherwise, would point to the issues related to dependence and problems related to withdrawal symptoms. These symptoms or syndrome, if they appear in the acute form may be potentially problematic, and consequently, the nursing care plan must evolve around this core issue also (Banks et al., 2000, 1249-1254). Care Plan and Related Evidence: Dependence and Withdrawal: Alcohol or ethanol is a sedative anesthetic found in various proportions in liquor, wine, and beer. Alcohol produces a sedative effect by depressing the central nervous system (CNS). This effect causes the individual to experience relaxed inhibitions, heightened emotions, mood swings that can range from bouts of gaiety to angry outbursts, and cognitive impairments such as reduced concentration or attention span, and impaired judgment and memory (Porjesz and Rangaswamy, 2007, 131-141). Depending on the amount of alcohol ingested, the effects can range from feelings of mild sedation and relaxation, to confusion and serious impairment of motor functions and speech, to severe intoxication that can result in coma, respiratory failure, and death. Excessive or long-term abuse of alcohol can adversely affect all

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