ATI Real Life Clinical Scenario-Alcohol Use Disorder and Anxiety PDF

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Required for clinical hours! Answers to ATI real life scenarios for alcohol use disorder and anxiety. Answers from ATI scenario, textbook and ATI book. ...

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ATI Real Life Clinical Scenario: Alcohol Use Disorder

Please answer the following questions: 

Identify factors that increase the risk for alcohol use disorder. o Genetics / family hx o Chronic stress d/t socioeconomic factors o Hx of trauma, abuse, combat experience o Lower self esteem o Lower tolerance for pain and frustration o Few life success o Risk taking tendencies

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Identify the diagnostic testing for a patient admitted as a result of a motorcycle accident who has alcohol intoxication. o X-ray or left arm o CT of head and neck o Toxicology screen for BAC

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Identify interventions for the alcohol-abusing patient who has delirium tremens o Neuro assessment o Take vitals o Don’t leave the patient alone

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Identify priority assessments for the newly admitted patient who had a motor vehicle accident (MVA) who has alcohol intoxication.

o CAGE questionnaire o Fall risk assessment o Braden Scale o Numeric pain scale o CIWA 

Plan and prioritize evidence-based care for the patient in alcohol withdrawal who might develop delirium tremens. o Seizure precautions o Promote a low stimulation environment



Identify important nursing considerations for medications for alcohol withdrawal. What are those medications? o Lorazepam 

Watch for respiratory depression and sedation



Only for acute use, not long term

o Naltrexone 

Can precipice withdrawal symptoms if the patient is not completely detoxified from alcohol

o Topiramate 

Monitor for oligohydrosis: take temperature and monitor for decreased sweating, closely monitor patient during exercise



Complete an accurate and effective SBAR communication tool.

o S: found patient lying at the foot of the bed looking anxious, IV hanging from arm. Pt is alert and responsive o B: 45-yo white male who had an MVA yesterday. Brought into ED with abrasions form the accident and alcohol intoxication (BAC 2.75). PMH of gastritis and esophagitis. Transferred to med surge. o A: AAOx2 (not alert to time), nausea with dry heaves. Moderate tremor of upper extremities. Anxious and restless. No auditory or visual disturbances but says he “feels bugs all over me”. Complains of mild HA. VS: BP 160/94, T 37.9 C, HR 106 and RR 24 which have increased since 0000. CIWA = 23 o R: needs antiemetic and medication for agitation and withdrawal (lorazepam) 

Recognize and list effective and ineffective coping skills in a patient who abuses alcohol. o Denial as a maladaptive coping mechanism to refuse to admit an alcohol use disorder o Displacement as an ineffective coping mechanism when yelling at staff members at things that aren’t their fault o Restating as an effective coping mechanism by the nurse of the patient’s words

ATI Real Life Clinical Scenario: Anxiety Disorder

Please answer the following questions: 

Identify factors that increase a patient’s risk for anxiety. o Women

o Medical conditions o Adverse effects of medications 

Identify interventions for a patient who has anxiety. o Restating patients concerns o Remain with patient during the worst of the anxiety attack to provide reassurance o Perform a suicide risk assessment o Enhance self-esteem by encouraging positive statement and discussing past achievements o Assist the patient to identify defense mechanism that interfere with recovery

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Identify priority assessments for the newly admitted patient who has anxiety o EKG o Chest X-ray o Blood specimen o Hamilton-A

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Plan and prioritize evidence-based care for patients who have acute anxiety. o Relaxation techniques o Modeling o CBT o Systematic desensitization o Flooding

o Response prevention o Thought stopping 

Identify important nursing considerations for medications used to treat anxiety. What are those medications? o Lorazepam 

Watch for respiratory depression and sedation



Only for acute use, not long term

o Escitalopram 

Report changes in patient behavior because it could be associated with an increase of suicidal ideation



Complete an accurate and effective SBAR communication tool. o S: Simpson admitted to inpatient mental health unit for anxiety. She presents restless and fidgety, poor concentration and has chest pain and SOB o B: 22-yo African American Female with PMH of GAD. Previously taken paroxetine 20 mg Po daily but hasn’t taken it the past 2 weeks o A: VS: HR 115, BP 148/76, RR 32, SpO2 96% on RA, Temp 37.0C. Hamilton A scale = 26. Unable to concentrate on answering questions d/t increased anxiety. Patient paces, wringing hands and rocks o R: requesting a prescription for lorazepam...