Alcohol Withdrawal Orders



Name____________________

Employee #_______________

CIWA Scavenger Hunt

1. How often is a patient’s CIWA score assessed and documented at minimum, according to the CIWA order-set?

a. Every 2 hours

b. Every 8 hours

c. Every 30 minutes

d. Every 4 hours

2. If the patient scores 14 on the CIWA-Ar scale, how much Ativan would you give and how often?

a. None

b. 1 mg IV/PO Q15 minutes

c. 4 mg IV/PO Q30 minutes

d. 2 mg IV/PO Q30 minutes

3. If the patient scores 16 on the CIWA-Ar scale, are you supposed to give 4mg IV Q15 minutes until CIWA-Ar is less than or equal to 15?

a. Yes

b. No

c. Maybe

d. Unsure

4. During the admission assessment of a patient, he tells you that he does drink

alcohol and usually drinks a pint of vodka per day. What other information do you

need from this patient?

a. The day and time of his last drink of alcohol.

b. Information about seizures during a period of alcohol withdrawal in the past.

c. Any information concerning difficulty during a period of alcohol withdrawal

in the past.

d. All of the above

5. A total score of 22 on the CIWA-Ar scale indicates that the patient:

a. Does not need medication

b. Is having severe withdrawal symptoms

c. Is having mild withdrawal symptoms

d. Is having moderate withdrawal symptoms

6. A total score of 22 on the CIWA-Ar scale indicates administering Ativan or Phenobarbital how often?

a. 2mg IV Ativan and 130mg IV phenobarbital every 30 minutes

b. 0mg IV Ativan and 0mg IV phenobarbital every 15 minutes

c. 4mg IV Ativan and 130mg IV phenobarbital every 15 minutes

d. 4mg IV Ativan and 130mg IV phenobarbital every 30 minutes

7. How often must you monitor a patient who has a CIWA-Ar score of less than 8?

a. Every hour x 4 consecutively, then every 4 hours

b. Every 30 minutes

c. Every 15 minutes

d. Every 8 hours

8. What types of problems might be seen with alcohol withdrawal?

a. Delirium tremors

b. Seizures

c. Anxiety

d. Vomiting

e. Hallucinations

f. All of the above

9. In addition to the CIWA-Ar assessment score, what additional monitoring does a

patient who is withdrawing from alcohol and on the alcohol withdrawal order set

require:

a. Pulse oximetry

b. Vital signs at least every 4 hours

c. Sedation score (RASS) every 4 hours and with each dose of Lorezapam (Ativan) administered

d. All of the above

10. What scale is used to assess the sedation level of the patient?

a. RASS Scale

b. Conscious Sedation Assessment Scale

c. Aldrete Scale

d. Glascow Coma Scale

11. Where is the sedation scale (RASS) located in EPIC?

       a. Head to Toe doc flow sheet

       b. Vital Signs doc flow sheet and CIWA flowsheet

       c. Daily Cares/Safety doc flow sheet

d. Intake and Output doc flow sheet

12. When can the CIWA-Ar assessment (not the actual orderset) be discontinued:

a. When CIWA-Ar is less than 8 for 72 hours

b. When CIWA-Ar is less than 15 for 72 hours

c. When CIWA-Ar is less than 20 for 72 hours

d. The CIWA-Ar is continued as long as the patient is in the hospital.

13. A total score of 14 on the CIWA-Ar scale indicates a CIWA and RASS assessment be performed and documented how often?

a. Assess and document CIWA Q15 minutes until CIWA < or = 15 and RASS prior to any dose administration

b. Assess and document CIWA QH until CIWA is < or = 8 x 4H then Q4H and RASS prior to any dose administration.

c. Assess and document CIWA Q30 minutes until CIWA < or = 8 and RASS prior to any dose administration.

d. Assess and document CIWA Q4H and discontinue after 72 hours

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