The nurse caring for a 46-year-old male who has been drinking heavily for 3 years is aware of the potential for alcohol withdrawal syndrome based on the knowledge that physiologically:
1. Alcohol is a stimulant that increases gamma-aminobutyric acid (GABA).
2. The neurotransmitters inhibit impulses on the neurons.
3. The CNS has become accustomed to the depressant effects of the alcohol and CNS excitability develops when alcohol is no longer present.
4. The neuroreceptors in the brain can begin to initiate a chemical reaction of normalcy.
3
Rationale 1: Alcohol suppresses the production of GABA. When alcohol is withdrawn, GABA may resume normal function which is to inhibit transmission of impulses.
Rationale 2: Neurotransmitters are usually balanced between inhibitory and stimulatory. In the presence of alcohol, transmitters are inhibited. With the absence of alcohol, the transmitters become stimulated.
Rationale 3: When exposed to repeated doses of alcohol, the central nervous system (CNS) becomes accustomed to the depressant effects of the alcohol and produces adaptive changes in an attempt to function normally. In the absence of or with a significant decrease in the amount of alcohol, chaos erupts within the CNS. When alcohol is no longer acting as a depressant, the compensatory actions cause excessive CNS excitability.
Rationale 4: With the withdrawal of alcohol, neuroreceptors do not regain normalcy. Instead they are prone to become overstimulated due to the depressant effect of alcohol.
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