Detox Detox Safety and Monitoring 2 — Questions and Answers
Question 1: How often should CIWA-Ar scores typically be reassessed in a patient with moderate alcohol withdrawal?
- Every 1–2 hours until stable (Correct answer)
- Once per day
- Every 10 minutes continuously
- Only at admission and discharge
Correct answer: Every 1–2 hours until stable
Moderate withdrawal requires frequent reassessment (every 1–2 hours) to detect rapid deterioration and adjust medication doses.
Question 2: What is the role of a 1:1 sitter or continuous observation in a detox unit?
- To ensure patient safety, prevent elopement, and monitor for sudden deterioration (Correct answer)
- To provide entertainment for bored patients
- To administer all medications without nursing oversight
- To replace physician assessments
Correct answer: To ensure patient safety, prevent elopement, and monitor for sudden deterioration
A continuous observer keeps high-risk detox patients safe from falls, self-harm, or sudden medical events, alerting staff immediately.
Question 3: Which medication reverses opioid toxicity in an emergency and is kept available in US detox settings?
- Naloxone (Narcan) (Correct answer)
- Methadone
- Clonidine
- Buprenorphine
Correct answer: Naloxone (Narcan)
Naloxone is an opioid antagonist that rapidly reverses opioid-induced respiratory depression and is required emergency equipment in detox facilities.
Question 4: What is the significance of monitoring glucose levels in patients admitted for alcohol detox?
- Alcoholics are prone to hypoglycemia due to glycogen depletion and poor nutrition (Correct answer)
- Alcohol always causes hyperglycemia
- Glucose levels are irrelevant in detox
- Glucose monitoring only applies to diabetic patients
Correct answer: Alcoholics are prone to hypoglycemia due to glycogen depletion and poor nutrition
Chronic alcohol use depletes liver glycogen stores, and poor nutrition puts detox patients at risk for life-threatening hypoglycemia.
Question 5: What is the purpose of QTc interval monitoring in patients receiving certain detox medications?
- To detect drug-induced cardiac arrhythmia risk (Correct answer)
- To measure kidney filtration rate
- To assess liver synthetic function
- To monitor for respiratory depression
Correct answer: To detect drug-induced cardiac arrhythmia risk
Some medications used in detox (e.g., methadone) can prolong the QTc interval, increasing risk of fatal torsades de pointes arrhythmia.
Question 6: Why must urine drug screens be performed at admission to a medical detox program?
- To identify all substances present so withdrawal risks from each can be safely managed (Correct answer)
- To report patients to law enforcement
- To deny treatment to polydrug users
- To satisfy only insurance billing requirements
Correct answer: To identify all substances present so withdrawal risks from each can be safely managed
Identifying all substances used is critical because polydrug use (e.g., alcohol + benzodiazepines) significantly increases withdrawal severity and management complexity.
Detox Detox Safety and Monitoring 2
How often should CIWA-Ar scores typically be reassessed in a patient with moderate alcohol withdrawal?