A CASE PRESENTATION

OF
ALCOHOL
INTOXICATION
Prepared by:
Maricris A. Datinguinoo
BSU SN 2018
Alcohol intoxication, also known as
drunkenness among other names, is a
physiological condition that may result in
psychological alterations of consciousness.
Drunkenness is induced by the ingestion
or consumption of alcohol in a living body.
Alcohol intoxication is the result of alcohol
entering the bloodstream faster than it
can be metabolized by the body.
 The Filipinos are the second highest consumers
of alcohol in South East Asia (the Indonesians
are first), and the number one wine drinkers. It is
estimated that 5 million Filipinos drink on a
fairly regularly basis – it is believed that 39.9% of
the population drink on an irregular basis. A
relatively small number of people will seek
medical help for alcohol problems, but this is
likely due to the fact that most do not view it as a
medical matter even when their health has
deteriorated as a result of the abuse.
 DEMOGRAPHIC PROFILE
Name: Patient J.L.
Birthday: December 25, 1968
Age: 49 years old
Address: Balete, Batangas City
Chief Complain: Facial Abrasions, Headache and
abdominal pain

Admitting Diagnosis:
Multiple Physical Injuries related to
vehicular accident secondary to alcohol
intoxication

Source of Information: Patient & Relative

PATIENT’S HISTORY
HISTORY OF PRESENT ILLNESS

Patient J.L. was rushed in the Emergency

Room yesterday (November 28,2017) at 12:30 pm by
his cousin, because of facial injury, headache and
abdominal pain. According to him, he is drunk and
driving a motorcycle on his way home.
PAST MEDICAL HISTORY

Client has no known medical

history and this is the first time that
he was being hospitalized.’
FAMILY HISTORY

According to the patient, he was

already separated to his partner and
has no children. His mother has a heart
problem and Diabetes, his father is
hypertensive .
SOCIO-ECONOMIC HISTORY

 According to the patient, he is working as Brgy.

Official to their place and he is already 1 year in
service.
DEVELOPMENTAL HISTORY

 Patient J.L. is an undergraduate college

student taking Computer science in University
of Batangas and he work as a Nursing Aide for
1 year (1991-1992) in one of the hospital in
Batangas.
NUTRITIONAL HISTORY

According to the patient he doesn’t smoke,

he loves to eat salty foods, soft drinks and he is
drinking alcohol 4x a week.
HEAD TO TOE ASSESSMENT
Anatomy and physiology
ANATOMY OF THE NERVOUS
SYSTEM
 The brain is part of a body system called the
Central Nervous System, or CNS. The CNS is made
up of billions of neurons, or nerve cells, in the brain
and the spinal cord. The peripheral nervous system,
which includes neurons, forms a network that
carries information to the neck and arms, trunk,
legs, skeletal muscles, and internal organs.


What happens to the CNS after drinking? While all
body systems feel the effects of alcohol, the CNS is
particularly sensitive. That's because alcohol can
pass through the blood-brain barrier, reaching
neurons directly. Once alcohol touches these cells,
they are changed, resulting in changes in behavior.
 The Central Nervous System (CNS)
The CNS is responsible for taking in information through the senses,
motor function, thinking, understanding, and reasoning. This system also
controls emotion. The CNS includes the brain, the spinal cord, and the
nerves that come from it. The most important parts of the CNS are
protected by bones. The skull protects the brain, and the spine protects
the spinal cord.

Alcohol is a depressant of the CNS. That means that alcohol makes nerve
cells in the brain less excited, causing them to slow down. Does this
surprise you? People often think that alcohol is a “pick-me-up” experience
because it causes drinkers to become more animated and less reserved.
That's because the first areas affected by small amounts of alcohol are
those involved in inhibiting behaviors, which can cause an increase in
animation, an increase in talkativeness, and greater sociability. But there
are many indications that the brain is slowing down. Here are a few:

Altered speech
Hazy thinking
Slowed reaction time
Dulled hearing
Impaired vision
Weakened muscles
Foggy memory
 The Brain
The brain is made up of more than 100 billion neurons.
Each makes tens of thousands of connections. Alcohol
can damage or even kill neurons, perhaps changing
development of those parts of the teenage brain that are
still developing.

Alcohol is able to penetrate the brain because it can

cross the blood brain barrier. This means that it can
move from circulation in the blood into the brain cells.
Because it can touch brain cells directly, it is sometimes
said that “alcohol kills brain cells.” Scientists used to
think that once brain cells die, they can never come
back, but new research says that this may not be true.
Scientists now think that in some parts of the brain,
cells can regenerate, or come back.
 This summary provides information about the role of different parts of the
brain and how alcohol affects their functioning.

Ventral striatum and prefrontal cortex: These parts have connections

that make up the brain’s reward system and regulate impulsive behavior.
In a young person, drinking too much alcohol can affect those connections,
which are not finished developing yet. As a result, teens may do impulsive
things that they probably would not do under normal circumstances. This
is also the part of the brain that is affected first, causing behavior to
become looser and less guarded.

Hippocampus: This is the part of the brain that stores memory. It is still
maturing during adolescence. Even a small amount of alcohol can make
teens forget what they did or learned while they were drinking.

Cerebellum: This part works with the primary motor cortex to control
movement, balance, and complex motor functions. Drinking alcohol can
decrease motor function and slow reaction time. For example, when a
person is drunk, he or she may not be able to stand or walk a straight
line.
Frontal lobe: This section controls judgment, behavior, and emotion.
Alcohol may affect emotions, leading to crying, fighting, or a desire to be
close to another person.
 Reticular activating system: This part is in the
midbrain, and it controls sleeping and waking. Alcohol can
depress these systems, causing a person to pass out.

Medulla: This part is in the hindbrain, and it controls

heartbeats, breathing, and other functions. During heavy
drinking, these may slow or stop working altogether,
endangering an individual’s life.

Neurons: These are the nerve cells. Alcohol can reach and
enter these cells and damage, or even, at high enough
levels, kill them.

Blood vessels: At intoxicating levels, alcohol causes blood

vessels to relax and widen. At even higher levels, it can
shrink the vessels and increase blood pressure,
exacerbating such conditions as migraine headaches.
Pathophysiology
DIAGNOSTIC PROCEDURE
 CHEST XRAY
 An X-ray is an imaging test that uses small
amounts of radiation to produce pictures of the
organs, tissues, and bones of the body. When
focused on the chest, it can help spot
abnormalities or diseases of the airways, blood
vessels, bones, heart, and lungs. Chest X-rays can
also determine if you have fluid in your lungs, or
fluid or air surrounding your lungs.
CT SCAN

 A computerized tomography (CT) scan combines a

series of X-ray images taken from different angles
and uses computer processing to create cross-
sectional images, or slices, of the bones, blood
vessels and soft tissues inside your body. CT scan
images provide more detailed information than
plain X-rays do.
A COMPLETE BLOOD COUNT (CBC)
 A complete blood count (CBC) is a blood test used to
evaluate your overall health and detect a wide range of
disorders, including anemia, infection and leukemia.
 A complete blood count test measures several components
and features of your blood, including:
 Red blood cells, which carry oxygen
 White blood cells, which fight infection
 Hemoglobin, the oxygen-carrying protein in red blood
cells
 Hematocrit, the proportion of red blood cells to the fluid
component, or plasma, in your blood
 Platelets, which help with blood clotting
 Abnormal increases or decreases in cell counts as revealed
in a complete blood count may indicate that you have an
underlying medical condition that calls for further
evaluation.
DRUGS STUDY
 Name Classification Action Adverse Nursing
Reaction Responsibilitie
s

Cephalexin Antibiotic This drug Nausea, Advise patient

binds to one or vomiting, to take with
more of the diarrhea, meals to
penicillin- stomach pain enhance
binding Headache, absorption. If
BRAND NAME: proteins dizziness tablet must be
(PBPs) which Sleep problems crushed, mix
Daxbia, Keflex inhibits the (insomnia) with food or
final Vaginal itching beverage.
transpeptidatio or discharge. •Advise patient
n step of to maintain
DOSAGE:
peptidoglycan normal fluid
synthesis in intake while
250 mg ; 500 mg ;
bacterial cell using this
125 mg/5 mL ; wall, thus medication.
250 mg/5 mL ; inhibiting •Instruct
biosynthesis patient to
333 mg ;
and arresting report these
hydrochloride 500 cell wall symptoms to
mg ; 125 mg ; 750 assembly health care
 Name Classification Action Adverse Nursing
Reaction Responsibiliti
es

Mefinamic Non-Opioid Binds to CNS: Administer

acid Analgesic opioids Sedation, with food if GI
receptors and Dizziness, upset occurs;
inhibits the Headache, Monitor
reuptake of and patient
norepinephrin Confusion response,
e and CV: Give the drug
BRAND serotonin Hypotension, before the
NAME: Tachycardia, pain becomes
Ponstan Bradycardia intense
Dermatologic:
Sweating
Nursing Care Plans
HEALTH TEACHINGS
 Medical Management
 Instructed client as well as the significant others
about the indications and mechanisms of actions
of each drug that the doctor ordered so that
without hesitation they will really comply all the
medications given with them.
 Adherence to the medication promotes
improvement of condition.
 Outpatient (CHECK-UP)
 Instructed the client’s family to come back one
week after discharged for further follow-up and
evaluation of the client’s health condition. This is
very important so that the health condition of the
client will be evaluated if there is better
improvement. The physician should see and
examine the physical appearance of the client.
 Diet
 Taught the importance of eating green leafy
vegetables
 Encouraged intake of vitamin C, such as home
made lemonade and oranges because it will help
in fast wound healing.
 Increased intake of protein because this is
important for skin integrity.
 Increased intake of fruits and vegetables because
this can provide vitamins and minerals for
nutrition.
 Advise the client to avoid alcoholic beverages or to
limit his intake because alcohol interference with
the utilization of essential nutrients
 XII. PROGNOSIS
 The case of Mr. J.L. came up with good
prognosis
 The diagnosis for this criterion is good because
he showed understanding in the importance of
compliance/adhering to treatment regimen,
although he has a positive attitude but lacks
financial aspect was really an impact on him
considering as well that he is the only person
who works in the family