Nutritional status Hx Flashcards
What is the NHS recommended allowance for units of alcohol (weekly)?
14 units max (both men & women)
What is the translation of 14 units to everyday drinks?
14 units =
- 6 pints of average-strength beer OR
- 10 small glasses of low-strength wine.
What are the steps involved in assessing alcohol dependence?
- initial assessment
- alcohol misuse assessment
- severity of dependence assessment –>
- assessment of risk
What does the inital assessment of alcohol intake involve?
How is the alcohol misuse & severity of dependence assessment conducted?
alcohol misuse
- CAGE questionnaire (easiest tool during Hx)
- AUDIT (in hospitals)
severity of dependence
- SADQ
- LDQ
What is CAGE?
- A brief assessment which will only pick up severe alcohol misuse.
- ‐ CAGE is an acronym for 4 questions:
- Have you ever felt you ought to CUT down on your drinking?
- Have people ever ANNOYED you by asking you about your drinking?
- Have you every felt bad or GUILTY about your drinking?
- Have you ever had a drink first thing in the morning (EARLY MORNING) to steady your nerves or get rid of a hangover?
–> A positive answer to 2 questions suggests alcohol dependence
What is SADQ (severity of alcohol dependence)?
Please recall a typical period of heavy drinking in the last 6 months.
During that period of heavy drinking:
- The day after drinking alcohol, I woke up feeling sweaty.
- The day after drinking alcohol, my hands shook first thing in the morning.
- The day after drinking alcohol, my whole body shook violently first thing in the morning if I didn’t have a drink.
- The day after drinking alcohol, I woke up absolutely drenched in sweat.
- The day after drinking alcohol, I dread waking up in the morning.
- The day after drinking alcohol, I was frightened of meeting people first thing in the morning.
- The day after drinking alcohol, I felt at the edge of despair when I awoke.
- The day after drinking alcohol, I felt very frightened when I awoke.
- The day after drinking alcohol, I liked to have an alcoholic drink in the morning.
- The day after drinking alcohol, I always gulped my first few alcoholic drinks down as quickly as possible.
- The day after drinking alcohol, I drank more alcohol to get rid of the shakes.
- The day after drinking alcohol, I had a very strong craving for a drink when I awoke.
- I drank more than a quarter of a bottle of spirits in a day (OR 1 bottle of wine OR 7 beers).
- I drank more than half a bottle of spirits per day (OR 2 bottles of wine OR 15 beers).
- I drank more than one bottle of spirits per day (OR 4 bottles of wine OR 30 beers).
- I drank more than two bottles of spirits per day (OR 8 bottles of wine OR 60 beers)
* Imagine the following situation:*
- You have been completely off drink for a few weeks
- You then drink very heavily for two days
- I would start to sweat.
- My hands would shake.
- My body would shake
- I would be craving a drink
If alcohol misuse and depence is discovered during assessment, what are the next steps?
- severity of withdrawal (CIWA-Ar)
- problems arising from alcohol misuse on life (APQ)
- –> motivational intervention
What is CIWA-Ar (Clinical Institute Withdrawal Assessment of Alcohol Scale)?
take pulse & BP
each section is scored out of 7
- N&V
- tremor
- paroxysmal sweats
- anxiety
- agitation
- headache, fullness in head
- tactile disturbance
- auditory disturbance
- visual disturbance
- orientation & clouding of sensorium
What does a motivational intervention involve?
- helping people to recognise problems or potential problems related to their drinking
- helping to resolve ambivalence and encourage positive change and belief in the ability to change
- adopting a persuasive and supportive rather than an argumentative and confrontational position
What does assessment of risk cover when conducting an alcohol intake assessment?
- risk to self (including unplanned withdrawal, suicidality and neglect)
- risk to others
What are the interventions available for all those that abuse alcohol?
- motivational intervention
- promote abstinence OR moderate drinking as appropriate and prevent relapse
What interventions are available for all pts seeking help for their alcohol misuse?
- give information on the value and availability of community support networks and self-help groups (for example, Alcoholics Anonymous or SMART Recovery) and
- help them to participate in community support networks and self-help groups by encouraging them to go to meetings and arranging support so that they can attend.
What pharmacological Txs are available for those undergoing alcohol withdrawal?
What are the major health concerns regarding smoking?
