How to Answer Case Study Alcohol Questions (Complete Guide)

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This question relates to case study alcohol and requires a structured academic response.

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Use appropriate theories and support your answer with clear reasoning.

Key Explanation

This topic involves case study alcohol. A strong answer should include explanation, application, and examples.

Original Question

Case Study 149: Alcohol Withdrawal Scenario J.G., a 49-year-old man, was assessed in the emergency department (ED) 4 days ago’ He was diagnosed with alcohol intoxication and released after 8 hours to his brother’s care. He was readmitted to the ED 12 hours ago with a gastrointestinal (GI) bleed and is being transferred to the intensive care unit (ICU). His diagnosis is upper GI bleed and alcohol intoxication. You are assigned to J.G. for the remainder of your shift. According to the ED notes, his admission vital signs (VS) were 84/56, 110, 26, and he was vomiting bright red blood. He was given IV fluids and transfused 6 units of packed red blood cells (PRBCs) in the ED. On initial assessment, you note that J.G.’s VS are 102.2° F (39°C), 174/98, 110, 24. He has a slight tremor in his hands, is diaphoretic, and he appears anxious. He reports a headache and appears flushed. No report of vomiting, frank red blood or melena in the stools, according to the chart, for the past 5 hours. In response to your questions, J.G. denies he has an alcohol problem but later on admits to drinking approximately a fifth of vodka daily for the past 2 months. He admits to having seizures while withdrawing from alcohol in the past. He tells you that he “just can’t help it” and has strong urges to drink, but that he never means “to drink very much.” He has had trouble keeping a job over the past several months. Chart View Admission Laboratory Work Hgb 10.9 g/dL (109 g/L) Hct 23% ALT (formerly SGPT) 69 units/L AST (formerly SGOT) 111 units/L GGT 75 units/L ETOH 291 mg/dL (63 mmol/L) aPTT 35 seconds PT/INR 12 seconds/1 Hepatitis C Screening Negative 1. Which data from your assessment of J.G. are of concern to you? 2. What do the admission laboratory results indicate? 3. Which of the previous laboratory results specifically reflects chronic alcohol ingestion? 4. What are the 2 most likely causes of J.G.’s symptoms? 5. What is the most likely time frame for someone to have withdrawal symptoms after abrupt cessation of alcohol? CASE STUDY PROGRESS You discuss with J.G. and his brother about the history of his alcohol use. You conclude J.G. may be demonstrating behaviors of alcohol use disorder. 6. List the criteria for alcohol use disorder as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) and put an asterisk or star next to the ones J.G. demonstrates. 7. Based on the DSM-V criteria, how would you rate the severity of J.G.’s alcohol use? Explain your decision. No problem Mild Moderate Severe 8. What would be helpful for J.G.’s physician to know regarding J.G.’s substance use history? CASE STUDY PROGRESS J.G.’s physician arrives in the ICU and discusses with you the possibility of J.G. manifesting signs of alcohol withdrawal delirium. The physician writes several medication orders. 9. What medications are commonly prescribed for patients withdrawing from alcohol? Select all that apply. Thiamine, a B vitamin Beta blockers, such as propranolol Naltrexone (Revia), an opioid-reversal agent Benzodiazepines, such as lorazepam (Ativan) Clonidine (Catapres), an alpha-adrenergic blocker Acamprosate (Campral), an alcohol deterrent agent Antiepileptic drugs, such as carbamazepine (Tegretol) 10. Explain the rationale for each of the drugs used during acute alcohol withdrawal. 11. What chronic health problems are associated with alcoholism? GI: CV: Neurologic: Reproductive system: Fetus during pregnancy: Nutritional problems: Musculoskeletal: 12. What laboratory tests might the physician order to assess for nutritional deficiencies or other medical problems J.G. is experiencing? CASE STUDY PROGRESS J.G. experiences alcohol withdrawal delirium that lasts for 36 hours before subsiding. He did not experience any seizures this time. As his medical condition stabilizes, he is transferred out of the ICU to the hospital’s psychiatric unit. He tells you that he is “ready to go home” and does not want to “touch another drink” but admits that he needs help. 13. What medications might be prescribed to J.G. to assist him with sobriety? What would you discuss with J.G. concerning the treatment regimen, side effects and precautions of his medications? 14. What types of information and referrals will be discussed with J.G. before his discharge from the hospital? 15. J.G. is referred to the local Alcoholics Anonymous (AA) program. What strategy can be implemented to increase his likelihood of attendance at these meetings? CASE STUDY OUTCOME J.G.’s AA sponsor met with him while J.G. was still in the hospital, and the meeting went well. The day after his discharge from the hospital, J.G. attends his first AA meeting with his sponsor.

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