Nursing 1: Alcohol Withdrawal Assessment and NGT Care

This report provides a comprehensive overview of alcohol withdrawal assessment (AWA) and nasogastric tube (NGT) care, crucial topics in nursing. It details the three stages of alcohol withdrawal: mild, moderate, and severe, outlining the associated symptoms and timelines. The report emphasizes the importance of initial diagnosis, treatment of alcohol dependence, and assessment of organ damage. It also discusses the administration of multivitamins, electrolyte replacements (potassium, glucose, magnesium, and phosphate), and medications such as benzodiazepines to manage withdrawal symptoms. The report highlights the use of the CIWA-Ar score for medication management, the common side effects of alcohol withdrawal, and detailed NGT care procedures, including hand hygiene, formula preparation, and tube insertion techniques. References from Children's Health Care US, Davies (2012), Mainerova et al. (2015), and Mirijello et al. (2015) support the information presented.

Running Head: NURSING
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Nursing Objectives
Alcohol withdrawal assessment
(Student details :)
6/13/2019

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Alcohol Withdrawal Assessment and NGT care
Alcohol withdrawal assessment (AWA) is broken down into 3 steps:
Step 1: this step is known as the mild symptoms stage which generally occurs within 6 to
12 hours from the last alcoholic drink. The symptoms which characterize this stage
include nausea; anxiety, insomnia, and abdominal pain, which may starts 8 hours after the
last alcoholic drink (Mainerova et al., 2015).
Step 2: second step is termed as moderate symptoms which generally starts in between 12
to 48 hours since the last drink. The major symptoms are high blood pressure; unusual
heart rate, increased body temperature, and confusion, which usually begin 24-72 hours,
post the last alcoholic drink.
Step 3: now, step 3 is typically known as severe symptoms stage, and start from 48-72
hours since last drink. In this stage patient may feel hallucinations, seizures, fever, and
agitation, which usually starts in 2-4 days post the last alcoholic drink (Davies, 2012).
In this context, initiative during AWA starts with initial diagnosis as well as treatment of the
alcohol dependence. Later then, an assessment of particular conditions arisen due to alcohol
consumption and hence damage body organs should be discussed in detail. Besides, initiative
during AWA suggests that in the very beginning stage multivitamins including folate must be
given to the patient regularly. Apart from this, deficiencies of the human body elements such
as potassium, glucose, magnesium and phosphate also need to be compensated in the patient
body through medications. The patient of AWA needs to be assisted every day or sometimes
2 times in a day as it depends upon the condition of the improving patient (Mirijello et al.,
2015).
The medications which are given for avoiding any AW side effects are the benzodiazepines.
They act on the GABA system as well as mimic the impacts of alcohol on the human body
(Mainerova et al., 2015). For avoiding severe side effects, patients should be medicated
constantly throughout the whole withdrawal period, while directed through the CIWA-Ar
score. Furthermore, medication is been given to the patient in response to a CIWA-Ar score
so that they can be tapered off as soon as the patient’s condition recovers, thus they decrease
the risk of dependency and side effects. Here, the common side effects of AW are nausea,

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vomiting, anxiety, psychomotor agitation, insomnia, increased hand tremor, hallucinations,
illusions and grand mal seizures (Davies, 2012).
Apart from this, NGT care hand hygiene suggests that one should properly wash their hands
before measuring the right amount of formula. Then the formula should be warmed to the
desired temperature before clamping the tube (Children's Health Care US, 2019). Hand
hygiene is highly recommended and important hence after every step hands must be washed
with Dettol and sanitized as well.
The step by step process of NGT care is as follows:
 Obtain a physician’s orders for NG insertion
 Assemble all required equipment after washing your hands
 Measure the formula, warm it and then clamp the tube after checking tube placement
 Attach syringe to the feeding tube as well as pour the formula
 Unclamp the tube (Children's Health Care US, 2019).
References
Children's Health Care US, 2019. NASOGASTRIC TUBE FEEDING. [Online] Available at:
https://www.childrensmn.org/educationmaterials/childrensmn/article/15553/nasogastric-tube-
feeding/ [Accessed 10 June 2019].
Davies, N.J., 2012. Alcohol misuse in adolescents. Nursing Standard, 26(42), pp.43-50.
Mainerova, B. et al., 2015. Alcohol withdrawal delirium-diagnosis, course and treatment.
BIomedical Papers of the Medical Faculty of Palacky University in Olomouc, 159(1).
Mirijello, A., D'Angelo, C. & Ferrulli, A., 2015. Identification and management of alcohol
withdrawal syndrome. Drugs, 75(4), pp.353-65.