P22 · Withdrawal symptoms
Actual Emotions and mind
Definition
Shaking, sweating, agitation, or cravings after stopping a substance.- Stopping alcohol or drugs
- reduced doses
- Shaking
- sweating
- anxiety
- vomiting
- seizures
- confusion
- fast pulse
📋 Scenario
A heavy drinker admitted for surgery develops tremors on day 2.
Subjective (S): "I feel terrible and I'm shaking."
Objective (O): Tremor; sweating; pulse 112/min; anxious; day 2 after admission; heavy drinker.
Assessment tools for this scenario: CP-MIND Mood & Mind Screen CP-BREATH Breathing & Circulation Check
Validated scales to consider: PHQ-9, GAD-7, C-SSRS, NEWS2, SpO₂, ECG
**CarePath diagnosis:** Withdrawal symptoms related to stopping alcohol or drugs, as evidenced by shaking and sweating.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Use a withdrawal scale. | A withdrawal scale gives a consistent score of symptom severity, which guides when and how much medicine is needed. |
| Give medicines as ordered. | Ordered medicines calm the overactive nervous system and reduce the risk of seizures and confusion, and giving them as prescribed keeps doses safe. |
| Monitor vital signs. | Pulse, blood pressure, temperature and other signs can show worsening withdrawal early, so changes can be treated before they become dangerous. |
| Keep a safe quiet room. | A quiet, safe, low-stimulation room reduces agitation and the chance of injury if he becomes shaky, confused or has a seizure. |
| Report seizures or confusion urgently. | Seizures and confusion are serious complications that need immediate medical treatment, so they must be reported urgently. |
**Expected outcomes**
- Within 72 hours: withdrawal symptoms controlled, no seizures, vital signs stable, patient safe.
**Linking the data to the diagnosis**
The heavy drinker admitted for surgery says, "I feel terrible and I'm shaking." On day 2 the nurse records tremor, sweating, a pulse of 112/min and anxiety. These signs appeared after stopping alcohol, so this is an actual problem, not the underlying dependence. The nurse reports seizures or confusion urgently. The plan aims, within 72 hours, for controlled symptoms, no seizures, stable vital signs and a safe patient.
CarePath diagnosis
Withdrawal symptoms related to stopping alcohol or drugs, as evidenced by shaking and sweating.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Use a withdrawal scale. | A withdrawal scale gives a consistent score of symptom severity, which guides when and how much medicine is needed. |
| 2. Give medicines as ordered. | Ordered medicines calm the overactive nervous system and reduce the risk of seizures and confusion, and giving them as prescribed keeps doses safe. |
| 3. Monitor vital signs. | Pulse, blood pressure, temperature and other signs can show worsening withdrawal early, so changes can be treated before they become dangerous. |
| 4. Keep a safe quiet room. | A quiet, safe, low-stimulation room reduces agitation and the chance of injury if he becomes shaky, confused or has a seizure. |
| 5. Report seizures or confusion urgently. | Seizures and confusion are serious complications that need immediate medical treatment, so they must be reported urgently. |
Expected outcomes
- Within 72 hours: withdrawal symptoms controlled, no seizures, vital signs stable, patient safe.
Linking the data to the diagnosis
The heavy drinker admitted for surgery says, "I feel terrible and I'm shaking." On day 2 the nurse records tremor, sweating, a pulse of 112/min and anxiety. These signs appeared after stopping alcohol, so this is an actual problem, not the underlying dependence. The nurse reports seizures or confusion urgently. The plan aims, within 72 hours, for controlled symptoms, no seizures, stable vital signs and a safe patient.