A patient is brought to the emergency department after a motor vehicle accident. The patient's speech is slurred. The nurse notes the smell of alcohol on the patient's breath and observes hand tremors. The patient's blood alcohol level is 0.4%
The nurse will expect to: a. find that the patient has lost consciousness within a short time.
b. administer naltrexone [ReVia] and prepare for gastric lavage.
c. give carbamazepine to reduce the risk of seizures.
d. provide mechanical ventilation and oxy-gen.
D
A blood alcohol level that exceeds 0.4% poses a substantial risk of respiratory depression. Pa-tients who are chronic abusers of alcohol may develop tolerance to other effects of increased blood levels, such as sedation, or behavioral changes, but there is very little tolerance to respira-tory depression. A patient with a blood alcohol level of 0.4% must be treated for respiratory de-pression, usually with mechanical ventilation. If this patient has developed tolerance, which is likely because loss of consciousness has not already occurred, the nurse cannot expect that the patient will lose consciousness. Naltrexone is not used for acute toxicity. Carbamazepine is used as an adjunct to benzodiazepines and may be used after this patient's immediate needs have been addressed.
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