Nursing 212

Health Differences Across the Lifespan 2 Study Guide

Alcohol abuse Alcohol is a CNS depressant that causes general depression of the CNS function primarily by enhancing GABA. The effect of alcohol on the CNS is dose dependent; low dosage primarily affects cortical brain function (thought processes, self-restraint, motor function). As dosage increases, the CNS depression deepens, reflexes diminish greatly, and LOC is impaired. Management of withdrawal includes use of chlordiazepoxide (Librium), diazepam (Valium), lorazepam (Ativan), and a regime of atenolol (a beta adrenergic blocking agent). Fetal Alcohol Syndrome Alcohol is the most commonly known etiological factor for mental retardation; pregnant women should not drink. Signs and symptoms in the newborn include drooping of the upper eye lids, a flat nose, a small mandible, mental retardation, and poor suck reflex. The three FAS facial features are: • A smooth philtrum: The divot or groove between the nose and upper lip flattens with increased prenatal alcohol exposure • A thin vermilion: The upper lip thins with increased prenatal alcoholexposure • Small palpebral fissures: The eye width decreases with increased prenatal alcohol exposure Central nervous system (CNS) damage is the primary feature of any Fetal Alcohol Spectrum Disorder (FASD) diagnosis. Prenatal exposure to alcohol, which is classified as a teratogen, can damage the brain across a continuum of gross to subtle impairments depending on the amount, timing, and frequency of the exposure as well as genetic predispositions of the fetus and mother. Structural abnormalities of the brain are observable. There is physical damage to the brain or brain structures caused by prenatal alcohol exposure. Structural impairments may include microcephaly (small head size) of two or more standard deviations below the average, or other abnormalities in the brain structure (agenesis of the corpus callosum, cerebellar hypoplasia). Microcephaly is determined by comparing head circumference (often called occipitofrontal circumference, or OFC) to appropriate OFC growth charts. During the first trimester of pregnancy, alcohol interferes with the migration and organization of brain cells, which can create structural deformities or deficits within the brain. During the third trimester, damage can be caused to the hippocampus, which plays a role in memory, learning, emotion, and encoding visual and auditory information, all of which can create neurological and functional CNS impairments as well. Neurological problems are expressed as either hard signs, or diagnosable disorders, such as epilepsy or other seizure disorders. Soft signs are broader, nonspecific neurological impairments or symptoms, such as impaired fine motor skills, neurosensory hearing loss, poor gait, clumsiness, and poor eye-hand coordination. Marchiava-Bignami disease is characterized by atrophy of the corpus callossum; no treatment is possible. Other disorders related to alcohol include alcoholic neuropathy, acute and chronic alcoholic myopathy, vitamin B12 deficiency, anemia, and alcoholic cerebella degeneration.

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