ETOH

Your best bet would be to just follow what the medical team is telling you. If you want specific advice about your family member from the internet and not their doctors, /r/askdocs will give you more information. We cannot give medical advice here.

For your own learning I can give you some information about alcoholism. I feel it was not covered near well enough in nursing school for how common it is.

There is no such thing as "end stage" alcoholism. There is end stage Cirrhosis, which may be a consequence of alcoholism - and comes with a lot of complications such as esophageal varices, ascites, vitamin deficiencies, hepatic encephalopathy, GI Bleeds, DIC, and more. There is delirium tremens, which is severe withdrawal. There is alcoholic hepatitis and acute pancreatitis that may be related to binge drinking on top of alcoholism and chronic pancreatitis that is associated with alcoholism. All of these are very serious and potentially fatal.

Generally plan of care heavily depends on the diagnosis.

  • For cirrhosis in early stages, there's no turning back but life can be extended by cutting out alcohol. In later stages the only "cure" is a liver transplant and life expectancy is very short - maybe 1-2 years max. There are medicines and procedures that can be done to buy time by preventing/treating complications and improve quality of life, but the only cure is transplant. These complications, medicines, and procedures could be a whole day long lecture of their own.

  • For alcohol withdrawal the care plan is benzos, airway protection, and up to ICU level of care through the acute stages. Then, once out of that acute stage, medicines to reduce cravings with out or inpatient addiction counseling if the patient is amenable.

  • For pancreatitis is it pain management, bowel rest, dietary changes, parenteral nutrition, and sometimes surgical management (if necrotizing) are used. For chronic pancreatitis there is a lot more focus on alcohol cessation and diet planning with exocrine pancreatic insufficiency often requiring dietary enzymes given with meals.

  • For alcoholic hepatitis steroids are typically used along with shorter term treatments similar to that in cirrhosis - along with alcohol cessation resources.

/r/nursing Thread