ETOH withdrawal vs ICU delirium
I was once assigned an acute alcohol withdrawal patient (I’m a bedside RN). At the time of my first assessment, he was on hospital stay day 5, all of which took place in one ICU room. I received report from the off-going RN. I was told in report that he was beyond ETOH withdrawal and in full-blown ICU delirium. GCS 11 (E4, V2, M5). He had been drinking hard alcohol almost daily for multiple years, h/o ETOH withdrawal requiring intubation. My question is, can we really differentiate between ETOH withdrawal and ICU delirium? I understand neurons have an incredible capability of …. Adapting to fluctuations in CSF content, be it lower pH from drinking or critical hypernatremia (say from downing a hole jug of soy sauce to give the body a “cleanse”). So how would we tell the difference between acute ETOH withdrawal and ICU delirium if we don’t know that his neurons have adapted back to CSF without alcohol in it?
Episode on the Pituitary, Please
Would you do an episode on the pituitary gland? Which other glands does it control and how, and how it can dysfunction? Symptoms. Known causes of dysfunction. What tests determine how it is functioning and how to understand the results of the tests. Treatments of the various conditions. If a hypo-pituitary is causing hypothyroid but not affecting the other glands, is it possible/likely/typical that over time the pituitary function will decrease more and eventually other glands will also dysfunction?