“Alcohol Abuse” plus 2 more nursing article(s): NursingCrib.com Updates

Alcohol Abuse
Ethical Issue: Abortion
Congenital Adrenal Hyperplasia

Posted: 31 Jan 2011 06:20 PM PST

Alcoholic Beverage

An alcoholic drink contains ethanol, commonly termed as alcohol. Alcohol is a psychoactive drug that is central nervous system depressant and rapidly absorbed in the bloodstream. It can be addictive and the state of alcohol addiction is known as alcoholism.

Physiologic Effects of Alcohol Use

When a person drinks alcohol, he or she may experience relaxation and loss of inhibitions initially. However, when large amount of alcohol is ingested intoxication may occur. The person who is intoxicated may experience the following manifestations.

Slurred speech
Unsteady gait
Lack of coordination
Decreased attention span
Reduced concentration
Impaired memory
Impaired judgment

An overdose of alcohol in a short period of time can result to the following manifestations:

Vomiting
Loss of consciousness
Respiratory depression

Physiologic Effects of Long-term Alcohol Use

Cardiac myopathy
Wernicke's encepalopathy
Korsakoff's psychosis
Pacreatitis
Esophagitis
Hepatitis
Cirrhosis
Leucopenia
Thrombocytopenia
Ascites

Treatment of Alcohol Overdose

Gastric lavage or dialysis. The procedure is performed to remove the drug from the systemic circulation.
Support of respiratory and cardiovascular functioning.

Alcohol Withdrawal

When an alcoholic withdraws from alcohol use, withdrawal symptoms usually starts at about 4 to 12 hours after a marked reduction or cessation of alcohol intake. The withdrawal may take 1 to 2 weeks. It can be life-threatening thus, prompt treatment and management is required or necessary.

Symptoms of alcohol withdrawal are:

Coarse hand tremors
Sweating
Elevated pulse
Increase blood pressure
Insomnia
Anxiety
Nausea and vomiting

Delirium Tremens (DT's)

In cases where the withdrawal signs and symptoms are not treated or becomes severe, the condition may progress to a condition called delirium tremens. Delirium tremens is an acute episode of delirium that is mainly caused after a long period of drinking and being stop abruptly and the person experiences withdrawal. It may also be triggered by head injury, infection, or illness in people with a history of heavy use of alcohol

Signs and Symptoms of delirium tremens:

Transient hallucinations
Seizures
Delirium

Management for Alcohol Withdrawal

Detoxification under medical supervision
For mild alcohol withdrawal symptoms and the client can abstain from alcohol, home treatment is possible.
For severe cases where the client cannot abstain from alcohol during detoxification, a short admission (about 3-5 days) is done.
Safe withdrawal is accomplished through the administration of benzodiazepines such as Chlordiaxepoxide (Librium), Lorazepam (Ativan) or Diazepam (Valium) to suppress the withdrawal symptoms.

Ethical Issue: Abortion

Posted: 31 Jan 2011 06:04 PM PST

Overview

One of the most ethical dilemmas the society is facing for decades is the issue on abortion. There are many strong arguments about the issue for those who are in favor and against it. Abortion is defined as pregnancy termination. It could be done intentionally (by choice) or accidentally as in miscarriage. Abortions caused by rape, incest and possible health concerns to mother or baby constitute just 7%. Social and personal issues are the cause for rest of the abortions.

Facts on Abortion

Approximately 60% of abortions are performed on single women.
Deciding whether to abort or keep the baby or give it up for adoption is a hard decision to make and may lead to post-abortion trauma.
When a woman decides to go for an abortion, the decision is NOT done impulsively. However, the preceding act might be impetuous.
Half the percentage of women getting an abortion done is below 25 years of age.

Issue on Abortion

The issue on abortion is impossible to solve. What an individual can do is to understand the different aspects of the argument so that when that person is faced with the ethical dilemma he or she would be able to make rational, educated and thoughtful decisions in dealing with the situation. Debates are usually focused on politics and the law. However, behind the debates are more fundamental ethical questions which are not always given specific attention they deserve.

Arguments AGAINST abortion

A growing embryo is considered a human being with heart beats initiating as early as the 21^st day age of gestation.
Unplanned pregnancies may be proved to be wanted later.
Terminating a pregnancy is being unmerciful to the unborn child.
If the mother has financial difficulty raising the child after giving birth choosing adoption is an alternative that would honor the baby's right to live.
Abortion presents life-threatening complications and death. These complications include infection, sepsis and recurrent miscarriages.
The woman may suffer from serious psychological impairment (depression and guilt) after abortion.

Arguments IN FAVOR of abortion

The life of the baby depends on the mother's health and it would be best for the mother to choose for herself either she wants the baby or not.
The mother is the one who will be going through the actual labor, continuing pregnancy and giving birth to the baby. In addition to that she will be the one to parent the child together with her daily life obligations and responsibilities. Thus, she can decide on what she wants.
Restricting abortions would cause an elevation of the illegal and unsafe abortion percentage. Once made legal abortion complications will most likely be prevented as people can receive the care they need during an abortion.

Congenital Adrenal Hyperplasia

Posted: 31 Jan 2011 06:00 PM PST

Definition

Congenital adrenal hyperplasia (CAH) is a genetic disorder of the adrenal glands which involves a deficiency of an enzyme involved in the synthesis of cortisol, aldosterone, or both.

Frequency

About 1 in 10,000 to 18,000 children are born with congenital adrenal hyperplasia.

Review of Related Anatomy and Physiology

The adrenal glands are two bean-shaped glands curved over the top of the kidneys. It has a glandular (cortex) and neural tissue (medulla) parts. The central medulla region is enclosed by the adrenal cortex, which contains three separate layers.

The adrenal cortex is responsible for producing three major groups of steroid hormones known as the corticosteroids. The hormones are the following:

Mineralocorticoids (aldosterone) – important in regulating the mineral or salt content in the blood, particularly the sodium and the potassium ions. The target organ of this hormone is the kidney tubules which is the one responsible for reabsorbing the minerals selectively or allowing them to be excreted out from the body. Increase aldosterone results to increase sodium retention by the kidney tubules and excretion of the potassium. When sodium increases the water also increases or follows. Thus, mineralocorticoids help in the regulation of water and electrolyte levels (equilibrium) in the body.
Glucocorticoids (cortisone and cortisol) – promotes the normal cell metabolism which helps the body to counteract the stressors (long-term) primarily by elevating glucose levels in the blood. These hormones are also called hyperglycemic hormones as their triggers the breaking down of fats and proteins into glucose.
Sex hormones (androgens) – produced by the adrenal cortex throughout the life in relatively small amounts. Hypersecretion of the sex hormones leads to masculinization regardless of the sex. Dramatic results are noted in females as they grow beard, a masculine body pattern of hair distribution and other male attributes.

Causes

Inherited as an autosomal recessive trait
People with congenital adrenal hyperplasia lack an enzyme needed by the adrenal gland to make the hormones cortisol and aldosterone.

Pathophysiology

In congenital adrenal hyperplasia (CAH), the affected individuals lack the enzyme needed by the adrenal glands to form and produce the other two hormones – cortisol and aldosterone. Absence of these hormones results to the increase production of the third hormone produced by the adrenal cortex which is the SEX HORMONES or the ANDROGENS. This causes males characteristics to early in childhood instead of normally appearing during the puberty period. In females, male characteristics appear inappropriately as early as the fetal life.