Page 2303 - Saunders Comprehensive Review For NCLEX-RN

1. Vitamin deficiencies
a. Vitamin B deficiency causing peripheral
neuropathies
b. Thiamine deficiency, causing
Korsakoff’s syndrome
2. Alcohol-induced persistent amnesic disorder, causing
severe memory problems
3. Wernicke’s encephalopathy, causing confusion, ataxia,
and abnormal eye movements
4. Hepatitis; cirrhosis of the liver
5. Esophagitis and gastritis
6. Pancreatitis
7. Anemias
8. Immune system dysfunctions
9. Brain damage
10. Peripheral neuropathy
11. Cardiac problems
IV. Alcohol Withdrawal
A. Description
1. Early signs develop within a few hours after cessation
of alcohol intake.
2. These signs peak after 24 to 48 hours and then rapidly
disappear, unless the withdrawal progresses to
alcohol withdrawal delirium.
3. At the onset of withdrawal (Box 66-2), follow unit or
agency protocol using specified withdrawal
assessment scales.
4. Chlordiazepoxide may be prescribed for acute alcohol
withdrawal and is usually given orally, unless a more
immediate onset is required (benzodiazepine
medications would decrease the withdrawal
symptoms because of cross-tolerance; see Chapter 68
for a list of benzodiazepines).
5. An intramuscular injection of vitamin B (thiamine)
1
followed by several days of oral administration is
usually prescribed to prevent Wernicke’s
encephalopathy.
B. Withdrawal (see Box 66-2)

C. Delirium tremens: The state of delirium usually peaks 48

to 72 hours after cessation or reduction of intake (although it can
occur later) and lasts 2 to 3 days (Box 66-3).

Withdrawal delirium is a medical emergency. Death can occur from myocardial

infarction, fat emboli, peripheral vascular collapse, electrolyte imbalance, aspiration
pneumonia, or suicide.

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