Brian Johnson is a 21-year-old college senior who comes to the university counseling center for an evaluation. Brian was referred by his resident advisor, who saw him intoxicated seven times in the past month. Brian has missed multiple classes because he was hungover from drinking the night before and he recently got a ticket for public drunkenness.
Answer the following questions from your perspective as his psychiatric nurse practitioner in APA format.
1. Identify one screening tool you could use to determine if Brian has a problem with drinking. Why is this tool appropriate to use in this situation?
2. What information or aspects about Brian’s drinking would be important to know in order to identify a diagnosis of alcohol use disorder?
3. What symptoms would Brian exhibit if he were having acute alcohol withdrawal symptoms? If he were exhibiting signs of acute alcohol withdrawal, what would be your next step?
4. Identify one resource in your community where a patient could get treatment for substance abuse. Include a link to this resource.
5. If you completed a psychiatric interview with Brian and identified alcohol use disorder, what laboratory tests would important to order?
a. Suppose his AST and ALT values were three times the normal value. What would this indicate?
b. Suppose his ammonia level was three times the normal value. What would this indicate? What medication might you order to address the high ammonia level?
6. If Brian described increased cravings and urges to drink, what medications would you consider? What doses might be ordered? What would be the most important medication teaching you could provide to Brian about these prescribed medications?
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