What are the alternate explanations for her change in mental status?
The patient is experiencing anxiety and restlessness with a falling blood alcohol level. She has some Type A (anxiety, restlessness) as well as some Type B (hypertension, tachycardia) symptoms. In addition, she has a history of significant AWS on previous admission, and her alcohol history suggests very heavy chronic excessive use. Over the next 12 hours, she showed no improvement in mental status, her vital signs showed a blood pressure of 110/75, heart rate of 130, RR of 26 and rectal temperature of 101F. She was unable to take nutrition. She was transferred to a medical facility. Physical examination showed her to be jaundiced and heavily sedated. She slurred her words, but was able to slowly answer questions. She winced on right upper quadrant palpation. She was oriented to person, but not to place. She had asterixis (liver flap), and had very uncoordinated movements. She did not realize she had been transferred to a medical facility. Her PT was 3x control, her PTT was 2x control,
