J Neurosci Nurs. 2020 Dec;52(6):316-321. doi: 10.1097/JNN.0000000000000543.
Caring for patients experiencing alcohol withdrawal syndrome can be challenging. Patients 65 and older are at increased risk for alcohol withdrawal syndrome related complications. The higher prevalence of co-morbidities, including cognitive impairment, longer drinking history and greater sensitivity to alcohol withdrawal syndrome treatment are the result of decreased ability of the brain to adapt to stressors such as illness, trauma, or surgery.
Symptoms may appear earlier from the last drink and present with a wide range of symptoms. The most effective interventions require high-quality nursing care delivery to prevent, decrease the severity and shorten the duration of delirium.
Strategies that help minimize these challenges starts with obtaining the patient's selfreport of their alcohol use history. Nurses should be diligent in their monitoring for signs of active alcohol withdrawal. Screening and assessment tools such as the Clinical Institute Withdrawal Assessment for Alcohol-Revised should guide pharmacological management. To support nurses in identifying delirium tremens, this manuscript seek to describe the underlying pathophysiology, key assessment components and nursing management of delirium tremens in the older adult.
照顾经历酒精戒断综合征的患者可能具有挑战性。65 岁及以上的患者发生与酒精戒断综合征相关并发症的风险增加。共病的更高患病率,包括认知障碍、更长的饮酒史和对酒精戒断综合征治疗的更高敏感性,是大脑适应疾病、创伤或手术等应激源的能力下降的结果。
症状可能从上一次饮酒后更早出现,并呈现出广泛的症状。最有效的干预措施需要高质量的护理服务提供,以预防、减轻严重程度并缩短谵妄的持续时间。
帮助最小化这些挑战的策略始于获取患者对其饮酒史的自我报告。护士应密切监测是否有活跃的酒精戒断迹象。筛查和评估工具,如修订后的临床戒断评估量表,应指导药物管理。为了支持护士识别震颤谵妄,本文旨在描述老年患者震颤谵妄的潜在病理生理学、关键评估成分和护理管理。