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Bùi An Phú đang tìm kiếm từ khóa Which question would the nurse ask to determine tolerance in a patient who drinks alcohol? được Update vào lúc : 2022-10-17 13:08:06 . Với phương châm chia sẻ Bí kíp về trong nội dung bài viết một cách Chi Tiết 2022. Nếu sau khi Read Post vẫn ko hiểu thì hoàn toàn có thể lại Comments ở cuối bài để Mình lý giải và hướng dẫn lại nha.What is the CAGE questionnaire?
Nội dung chính- Which medical condition occurs when the patient drinks more than 5 drinks a day?Which direct serum biomarker would help detect moderate alcohol intake in a patient?Which nursing action is appropriate when caring for a patient from a culture different from the culture of the majority quizlet?Which type of withdrawal would the nurse monitor for in a patient who scores a 10 on the Clinical Institute Withdrawal Assessment?
The CAGE questionnaire is a series of four questions that doctors can use to check for signs of possible alcohol dependency. The questions are designed to be less obtrusive than directly asking someone if they have a problem with alcohol.
CAGE is an acronym that makes the four questions easy to remember. Each letter represents a specific question:
Have you ever felt you should cut down on your drinking?Have people annoyed you by criticizing your drinking?Have you ever felt bad or guilty about your drinking?Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)?Each question requires a simple yes or no answer. Each yes answer increases the chances that someone may have an alcohol dependency. Generally, two or three yes answers suggest heavy alcohol use or alcohol use disorder.
Doctors sometimes attach more significance to certain questions. For example, many consider the final question about drinking in the morning to be the most important question, since it’s a sign that someone may be having symptoms of withdrawal.
There are a few similar tests that doctors use to check for alcohol or substance use disorder.
The most similar one is called the CAGE-AID questionnaire. The addition of AID stands for “Adapted to Include Drugs.” It’s the same four questions as the CAGE questionnaire, but adds drug use alongside drinking.
Similar tests used to check for signs of alcohol use disorder include:
- Michigan alcohol screening test (MAST). This is one of the oldest screening tests for alcohol use disorder. It includes 24 questions that ask about both behavior and negative consequences. It tries to evaluate someone’s long-term history, rather than their current state. Alcohol use disorders identification test (AUDIT). This 10-question test checks for both potentially dangerous drinking habits and alcohol dependence.
Fast alcohol screening test (FAST). This is a four-question test adapted from the AUDIT questionnaire that checks for drinking patterns that might increase someone’s risk of psychological or physical complications.TWEAK. This test includes five questions that check for signs of alcohol misuse, such as blacking out and having a very high tolerance.
It was originally developed to check for dangerous drinking habits in pregnant women.
There’s a strong stigma surrounding alcohol misuse and dependency. This can make it hard for doctors to effectively ask questions about a person’s drinking habits.
The CAGE questionnaire, along with related tests, try to remove any potential for personal judgement by asking very simple, direct questions that don’t accuse someone of any wrongdoing. For example, the second question asks how other people perceive their drinking, rather than asking how someone’s drinking directly affects those around them.
The CAGE questionnaire is reported to accurately identify people with alcohol dependence issues 93 percent of the time. This makes the CAGE questionnaire a relatively accurate, quick way to screen people for alcohol dependence without making someone defensive or upset.
The CAGE questionnaire is a list of four simple questions that’s used to check for signs of alcohol dependence. While it’s not a foolproof test, it can be a useful tool that only requires a minute or two of time and avoids some of the social stigmas surrounding alcohol use.
Think you can spot a patient who abuses alcohol? If so, here’s something that may curb your self-confidence: In a recent study, healthcare professionals failed to identify nearly half the patients with alcohol use disorders (AUDs) during their hospital stays.
The chance you’ll encounter patients with a drinking problem is high. In a large national survey in 2004, more than 20% of the U.S. population reported episodic binge drinking within the previous 30 days, and
15.9 million Americans said they drank heavily. The National Hospital Discharge Survey found that a principal alcohol-related diagnosis—for instance, alcohol dependence, liver cirrhosis, alcoholic psychosis, or alcohol abuse—accounted for roughly 424,000 hospital discharges among persons age 15 and older. (This statistic doesn’t include such alcohol-related conditions as alcohol cardiomyopathy, Wernicke-Korsakoff syndrome, or trauma linked to alcohol use.)
So unless you routinely screen
patients for AUDs, you’re likely to miss the opportunity to identify the problem and to incorporate this important information into the plan of care. As a result, serious alcohol-
related health consequences could go undiagnosed. Failure to screen also may mean missing the chance to prevent AUDs in patients risk.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends all healthcare providers screen every patient for AUDs. As a nurse, you have the ethical and legal
responsibility to meet this new standard of care.
Alcohol-related health risks
Alcohol consumption increases the risk of:
• liver cirrhosis
• Wernicke-Korsakoff syndrome (characterized by acute confusion, ataxia, and abnormal eye movements)
• alcoholic cardiomyopathy
• acute respiratory distress syndrome
• breast cancer
• injuries (such as falls in the elderly).
Understanding the range of alcohol use
Not all alcohol
use is dangerous. But if it causes or increases the risk of alcohol-related problems or complicates management of other medical problems, it’s definitely an issue.
For the general adult population, NIAAA recommends the following drinking limits:
• Men: fewer than five standard drinks daily or 15 drinks weekly
• Women: fewer than four standard drinks daily or eight drinks weekly
• Adults age 65 and older: no more than one
standard drink daily or seven drinks weekly.
For pregnant women, no level of alcohol consumption is safe.
A standard drink varies with alcohol type and glass size. (See How much alcohol does a standard drink contain? in the PDF format by clicking on the tải về now button.)
A greater danger to women and the elderly
Compared to a man’s body toàn thân, a woman’s generally contains less water. This means that the alcohol a woman consumes ends up being less diluted, causing
greater impairment lower consumption levels and raising the risk of alcohol-induced organ damage.
The elderly have a lower ratio of body toàn thân water to fat. Like women, they have less body toàn thân water to dilute the alcohol. Also, with age, hepatic blood flow decreases and liver enzymes become less efficient, impairing alcohol metabolism. As a result, elevated blood alcohol levels last longer and the risk of hepatic damage is higher. Also, aging impedes the body toàn thân’s ability to adapt to alcohol, reducing
tolerance for it. So elderly people may develop alcohol-related problems even if they’re drinking no more than they did when younger.
Screening for alcohol use
Screening can distinguish patients with low-risk alcohol use from those with risky use, harmful use, or dependence. The main purpose of most alcohol screening tools is to identify patients with AUDs who can benefit from early intervention and treatment. But you can use the same tools to screen patients risk
for alcohol-related medical consequences and alcohol withdrawal symptoms.
Screening opportunities
You may want to screen for AUDs as part of a routine examination, especially if the patient is a smoker, an adolescent, or a young adult. Other screening opportunities include:
• when a patient is prescribed a drug that could interact with alcohol
• when a female of childbearing age has the potential to become pregnant
• when a patient has a health problem that could be alcohol related, such as trauma, arrhythmia, hepatic disease, dyspepsia, depression, anxiety, or insomnia
• when a patient has a chronic illness that’s not responding to treatment, such as chronic pain, diabetes, a GI problem, cardiac disease, hypertension, or depression.
Screening instruments
In the 1970s, researchers began developing and testing self-report screening
instruments for identifying alcohol consumption, abuse, and dependence. These instruments (for example, the four-question CAGE questionnaire) were designed to distinguish persons with probable alcohol dependence from those without apparent dependence. However, they lack a means of differentiating across the continuum of alcohol use.
Instead, NIAAA recommends healthcare professionals use the Alcohol Use Disorders Identification Test (AUDIT). This tool asks 10 questions to determine how much
and how often the patient consumes alcohol, identify the pattern of alcohol use, and gauge whether the patient may have an AUD.
Clinical application
AUDIT is part of a screening algorithm described in NIAAA’s publication Helping Patients Who Drink Too Much: A Clinician’s Guide. Here are the four basic steps of the algorithm:
1. Ask about alcohol use. Start with the question. “Do you sometimes drink beer, wine, or other alcoholic beverages?” If the
patient answers “Yes,” ask, “How many times in the past year have you had five or more drinks in a day?” (For a woman, use four or more drinks). At this point, you can administer the AUDIT. If the patient isn’t currently drinking, find out about past alcohol use by asking, “Have you sometimes had alcoholic beverages during your lifetime?” Someone who is abstinent now but previously consumed large amounts of alcohol for long periods might be experiencing medical complications from earlier alcohol
use. Stay especially alert for this in elderly patients who’ve cut back on alcohol after using it for 40 years or more.
2. Assess for AUDs. Look for a maladaptive pattern of alcohol use that’s causing clinically significant impairment or distress
3. Advise and assist. State your conclusion and recommendations clearly. For instance, “You’re drinking more than is medically safe. I strongly advise you to cut down or quit, and I’m willing to help.” Gauge
the patient’s readiness to alter drinking habits.
4. Continue support. At each visit, document the patient’s alcohol use and review the goals.
Once you complete this process, you’ll have important information about the patient’s alcohol use. If your patient reports current alcohol consumption but screens negative for an AUD, emphasize the need to stay within maximum limits. As indicated, recommend lower limits of alcohol use depending on the patient’s medication use or
medical status. Advise a patient who is pregnant or may become pregnant to abstain totally.
A patient who reports one or more heavy drinking days in the past year or who has an AUDIT score of 8 or higher (if male) or 4 or higher (if female) needs further evaluation. The NIAAA recommends considering making a referral to an addictions specialist for assessment, although this isn’t practical in some settings.
If a patient is currently abstinent, assess for alcohol-related physical and
mental problems if he reports a history of exceeding recommended limits of alcohol consumption for a long period. This assessment may involve laboratory tests, such as liver function tests and thiamine levels, as well as evaluation of cardiovascular and mental status.
If a patient admitted for inpatient care is currently drinking high levels, assess for possible alcohol withdrawal every 4 hours over a 5-day period.
Screening as a standard of nursing care
The
approach outlined here is a guide to incorporating AUD screening into nursing assessment. By making such screening routine, you can make real inroads toward preventing and ensuring early intervention for AUDs and reducing the health consequences of alcohol use.
Selected references
Dawson D, Grant B, Li T. Quantifying the risks associated with exceeding recommended drinking limits. Alcohol Clin Exp Res. 2005;
29:902-908. www3.interscience.wiley.com/
journal/118650419/abstract. Accessed November 9, 2008.
Haack M, Adger H. Strategic plan for interdisciplinary faculty development. Subst Abus. 2002;23(3S):345.
National Institute on Alcohol Abuse and Alcoholism. Helping Patients Who Drink Too Much: A Clinician’s Guide. Updated 2005 Edition. ://pubs.niaaa.nih.gov/publications/Practitioner/CliniciansGuide2005/guide.pdf. Accessed November 9, 2008.
National Quality Forum. National Voluntary Consensus Standards for the Treatment of
Substance Use Conditions: Evidenced-Based Treatment Practices. Washington, DC: National Quality Forum; 2007.
Visit www.AmericanNursetoday.com for a complete list of selected references and the complete AUDIT tool.
Christine Savage is an Associate Professor and Director of the Community Health Masters Program the College of Nursing the University of Cincinnati College of Nursing in Cincinnati, Ohio.
Which medical condition occurs when the patient drinks more than 5 drinks a day?
Alcohol use disorder (sometimes called alcoholism) is a medical condition. It involves heavy or frequent alcohol drinking even when it causes problems, emotional distress or physical harm.Which direct serum biomarker would help detect moderate alcohol intake in a patient?
Gamma-Glutamyl Transferase GGT is an inexpensive and sensitive indirect marker of alcohol consumption. Even moderate drinkers (<60 g/week), especially men, show higher levels of GGT than abstainers do.Which nursing action is appropriate when caring for a patient from a culture different from the culture of the majority quizlet?
Which is the best action for the nurse to take when caring for a patient whose beliefs differ from those held by the majority population? Analyze the patient's beliefs to determine their significance.Which type of withdrawal would the nurse monitor for in a patient who scores a 10 on the Clinical Institute Withdrawal Assessment?
Scores of less than 8 to 10 indicate minimal to mild withdrawal. Scores of 8 to 15 indicate moderate withdrawal (marked autonomic arousal); and scores of 15 or more indicate severe withdrawal (impending delirium tremens). The assessment requires 2 minutes to perform (Sullivan, et al, 1989). Tải thêm tài liệu liên quan đến nội dung bài viết Which question would the nurse ask to determine tolerance in a patient who drinks alcohol?
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