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Alcohol's toxic effects on the body complicate your hospitalized patient's recovery. Learn to recognize an alcohol-dependent patient and take steps to minimize withdrawal symptoms.


EVE WINTERS, 54, underwent an uneventful abdominal surgical procedure 24 hours ago. She remains on q2h VS because her hematocrit level is low and she's mildly hypertensive. When you assess her at the beginning of your shift, she's alert and oriented, although somewhat anxious.


Forty-five minutes later, her roommate calls you to report that Ms. Winters has vomited and needs help. You find her sitting on the side of the bed with her intravenous (I.V.) catheter dislodged. She's trembling, febrile, and diaphoretic, with notably increased blood pressure, respirations, and heart rate. You encourage her to lie back with a cool compress, but she can't lie still in bed, follows your directions inconsistently, and speaks in an agitated manner. You begin to consider the potential explanations for her symptoms: an infection, electrolye imbalance, hypoxia, pulmonary embolism?


Another likely (though often overlooked) possibility is that Ms. Winters is alcohol-dependent. After 36 hours without a drink, she may be developing full-blown alcohol withdrawal syndrome.