Delirium Tremens Snapshot

AKA: DTs, Alcohol withdrawal

WHAT IS IT: Withdrawal symptoms that generally start a couple of days after an alcoholics last drink

SYMPTOMS: Auditory & visual hallucinations, nausea/vomiting, diarrhea, pins & needles, agitation, shaking, confusion, anxiety, palpitations, chest pains (MedlinePlus)

PHYSICAL ASSESSMENT: Fever, tachycardia, high blood pressure, pale skin color, diaphoretic, tremors, tachypnea

RISK FACTORS: Stopping chronic alcohol use abruptly

EMERGENT MEDICATIONS USED FOR TX: Lorazepam, Valium (benzodiazepines help prevent seizures)

OTHER MEDS THAT MAY BE USED: Folic acid, magnesium, multivitamin, thiamine injection, Famotidine (alcoholic gastritis), Zofran

POTENTIAL DRIPS/FLUIDS: Banana bag, IV fluids

ABNORMAL LABS COMMONLY SEEN: Click here to see the post listing commonly seen labs

TESTS: EKG, ETOH level, Mag, phosphorus, CBC, CMP, GABA, Urine drug screen, ABG’s

COMPLICATIONS: Seizures, myocardial infarction, liver complications, gastritis, Wernicke encephalopathy, Wernicke Korsakoff Syndrome, severe electrolyte disturbances, injury from seizures

TREATMENT GOAL: Prevent seizures, control agitation, control nausea & vomiting, and other uncomfortable symptoms, prevent injury

NURSING ORDERS/PROCEDURES: Seizure, fall, elopement precautions. Psyche consult as indicated for depression/SI/HI, CIWA (3)

AFTER CARE: AA meetings, Counseling,

DIFFERENTIAL DX: Opioid overdose, illicit drug use overdose, encephalopathy, stroke, amphetamine toxicity Click here for a more comprehensive list on emedicine.medscape.com)

REFERENCES:

MedlinePlus medical Encyclopedia
Emedicine.medscape.com
AAFP.org

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