Safety measures are necessary to prevent unintentional or intentional self-injury. Phenobarbital is usually prescribed to prevent and control seizures. Nausea and vomiting should be controlled with medication and nursing measures in order to prevent upper GI tract trauma and hemorrhaging. If the patient has esophageal varices, which are fairly common in conjunction with cirrhosis of the liver, they can rupture during an episode of strenuous vomiting and create an emergency situation. The nutritional status of the alcoholic patient should be evaluated before therapy is begun.
Many alcoholics have a vitamin deficiency, especially a deficiency of thiamine.
Finally, it should be remembered that withdrawal symptoms also may be seen in an accident victim, surgical patient, or other patient with a medical problem unrelated to alcohol but who also has a hidden drinking problem. When early symptoms of withdrawal first appear in the hospitalized patient, assessment should include a history of drinking patterns as well as an appraisal of health status with respect to physiologic changes attributable to alcoholism. Once the assessment is done, a care plan is developed to help meet specific needs. Because of the denial of alcoholism, the patient and family may not readily acknowledge and confront the problem. And, because it is a difficult disorder to deal with, health professionals may ignore it and join them in denying the problem.