AIIMS Delhi NO - 2017
Mental Health Nursing
Medium
An alcoholic patient stops alcohol consumption before 24 hours. He faced tremors, agitation, and confusion. What is the diagnosis?
Appeared in: AIIMS Delhi NO - 2017
Explanation
- The patient has a history of being an 'alcoholic,' indicating dependence.
- He stopped consuming alcohol, which is the trigger for withdrawal.
- The onset of symptoms (tremors, agitation, confusion) within 24 hours fits the typical timeline for early to moderate alcohol withdrawal.
- These specific symptoms are hallmark signs of the central nervous system becoming overexcited after the depressant effect of alcohol is removed.
- Therefore, the diagnosis is Alcohol Dependence Syndrome with active alcohol withdrawal.
Why Other Options Were Wrong
- Option B: 'Alcohol independence' is not a recognized medical or psychiatric term. It has no clinical meaning.
- Option C: Side effects of alcohol occur during or immediately after consumption (intoxication), such as impaired judgment or coordination. The patient's symptoms are due to the absence of alcohol.
- Option D: Alcohol tolerance is a chronic adaptation where a person needs more alcohol to feel its effects. It is a component of dependence but does not describe the acute symptoms that occur upon stopping alcohol.
Related Visual
Clinical Relevance
- Nursing practice connection: Safe nursing care depends on performing Diagnosis of Alcohol Withdrawal Syndrome in the correct sequence, documenting the action clearly, and monitoring for the expected response.
- Nurses must be vigilant in assessing any hospitalized patient's alcohol history, as withdrawal can be life-threatening and may be mistaken for other conditions.
- The Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale is a validated tool used by nurses to objectively measure the severity of withdrawal and guide treatment, typically with benzodiazepines.
- Early identification and management of withdrawal symptoms can prevent progression to delirium tremens, a medical emergency with a significant mortality rate.
How to Approach the Question
- First, identify the key elements in the clinical scenario: a patient with a history of alcoholism.
- Next, note the primary action: the patient has stopped drinking.
- Analyze the timeline of events: symptoms appeared within 24 hours of cessation.
- Correlate the presenting symptoms (tremors, agitation, confusion) with the timeline and patient history.
- Evaluate the given options. The symptoms are a direct result of stopping the substance the patient is dependent on, making 'alcohol withdrawal' the most accurate diagnosis.
- Eliminate other options: 'independence' is not a term, 'side effects' relate to intoxication, and 'tolerance' is a chronic feature, not an acute syndrome.
Concept Tested & Keywords
- Concept Tested: Diagnosis of Alcohol Withdrawal Syndrome
- Stem keywords: alcoholic patient, stops alcohol, 24 hours, tremors, agitation, confusion
- Lead-in keywords: What is the diagnosis?
- Clinical cues: The combination of a history of alcoholism with the acute onset of neurological and psychological symptoms after cessation of drinking is a classic presentation of withdrawal.
Question ID
Qg-5mnrPYWTwOJep51YpgX
Reference Book
E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 136-138
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 4228-4230
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 897-899
Practise the full AIIMS Delhi NO - 2017
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