1. The client/caregiver can list general facts about alcohol and alcohol abuse.
   1. Alcohol is a drug that causes central nervous system depression.
   2. It contains 200 calories per ounce and has no nutritional value. It is absorbed easily and can reach all areas of the body.
   3. Alcohol abuse or alcoholism is a disease with four main features.
      1. Craving or a strong need to drink
      2. Loss of control and not being able to stop drinking once you have begun
      3. Physical dependence and withdrawal symptoms, such as nausea, sweating, or shakiness after drinking has stopped
      4. Tolerance for alcohol and need to drink greater amounts of alcohol to get “high” or desired effect
   4. The signs and symptoms of alcohol intoxication will vary with the amount of alcohol ingested. The blood alcohol level is one method of measuring alcohol intake. A person with a blood alcohol level between .08 and .10 is considered legally intoxicated in most states.
   5. Some studies indicate that between 25% and 50% of people seen in medical situations have physical and emotional problems related to alcoholism. That number increases when people are seen in a mental health setting.
   6. The use of alcohol is growing in adolescents and underage drinkers. Often they will participate in binge drinking.
2. The client/caregiver can list the effects of alcohol (directly and indirectly) on the body.
   1. Specific brain and nervous system changes can be
      • Slower reaction time
      • Decreased inhibitions
      • Impaired concentration and memory
      • Impaired judgment and decision-making skills
      • Decreased physical control, such as loss of balance, slurred speech, or blurred vision
   2. Blood vessels may dilate, and hypertension can result.
   3. Irritation of the gastrointestinal tract can result in the following:
      • Bleeding
      • Diarrhea
      • Inability to absorb required nutrition
   4. Alcohol poisoning or an overdose of alcohol can lead to respiratory depression and even death.
   5. There is an increased risk of certain cancers (liver, esophagus, nasopharynx, and larynx).
   6. Permanent damage can occur to the liver, brain, and other organs.
3. The client/caregiver can describe the results and complications of alcohol abuse.
   1. Depression
   2. Drinking during pregnancy can result in birth defects.
   3. There is an increased risk of death from automobile accidents.
   4. There is an increased risk of injuries from falls and accidents.
      1. Alcoholics are 16 times more likely than others to die in falls.
      2. Alcoholics are 10 times more likely to become fire or burn victims.
      3. Alcohol is associated with between 47% and 65% of adult drownings.
      4. Forty percent of industrial fatalities and 47% of industrial injuries can be linked to alcohol consumption and alcoholism.
   5. There is an increased risk of suicide and involvement in homicide.
      1. Twenty percent of suicide victims are alcoholics.
   6. Family dysfunction, marital problems, and possible abuse can occur.
4. The client/caregiver can explain the CAGE test as one example of screening for alcoholism.
   1. The test consists of four questions for the person to answer. More than one positive response is a good indication that a problem exists.
   2. The questions are as follows:
      1. Have you ever felt the need to cut down on your drinking?
      2. Have you ever felt annoyed at criticism of your drinking?
      3. Have you ever felt guilty about something that happened while drinking?
      4. Have you ever felt the need for an eye-opener?
5. The client/caregiver can list signs and symptoms of alcohol withdrawal.
   1. Anxiety
   2. Agitation
   3. Irritability
   4. Tremors
   5. Sweating
   6. Seizures
   7. Delirium tremors
6. The client/caregiver can list treatments available.
   1. Alcohol abuse treatment programs such as Alcoholics Anonymous
   2. Inpatient programs
   3. Residential treatment
   4. Outpatient treatment
   5. Halfway houses
   6. Community-based treatment
   7. Employee assistance programs and referrals

Resources

Alcoholics Anonymous
212-870-3400
www.aa.org

Al-Anon Family Group Headquarters
800-356-9996
www.al-anon.alateen.org

National Institute on Alcohol Abuse and Alcoholism
www.niaaa.nih.gov

Substance Abuse and Mental Health Services Administration
www.samhsa.gov

National Council on Alcoholism and Drug Dependence
www.ncadd.org

Department of Health and Human Services Surgeon General’s Call to Action for the Prevention of Underage Drinking
www.surgeongeneral.gov

Employee assistance program

State or local mental health agencies

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. St. Louis: Mosby Elsevier.
Hitchcock, J. E., Schubert, P. E., & Thomas, S. A. (2003). Community health nursing: Caring in action. Clifton Park, NY: Thomson Delmar Learning.
Lutz, C., & Przytulski, K. (2001).Nutrition and diet therapy. Philadelphia: F. A. Davis Company.
Varcarolis, E. M. (2006). Manual of psychiatric nursing care plans. St. Louis: Saunders Elsevier.