SU & medical complications Flashcards

1
Q

reasons disease is a common complication of SUD

A
  • IV injection
  • drugs have pathogens
  • contamination of needles
  • chronic alcohol and drug use decreases immunity
  • malnutrition: an issue in SUD clients
  • bacteria such as Neisseria and Streptococcus on needle surfaces
  • SUD clients living in close proximity in unclean settings, increasing risk of communicable diseases such as TB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

bacterial infections seen in intravenous drug abusers

A
  • endocarditis
  • Necrotizing fasciitis
  • Skin abscesses/Cellulitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is endocarditis

A
  • When bacteria infect the valves of the heart
  • Bacteria normally found on the skin
  • Higher in IVDU
  • Treatment with ABX
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is Necrotizing fasciitis

A
  • Special danger to cocaine users
  • An infection in which subcutaneous tissues are attacked by bacteria normally found on the surface of the skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what bacterial infection is a special danger to cocaine users

A

Necrotizing fasciitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Skin abscesses/Cellulitis

A

Use of dirty needles, risk of sepsis if not treated with antibiotics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is pneumonia

A

Acute infection of the lung tissue, normally caused by bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

fungal pneumonia

A

Common complication of HIV infection and of heroin abuse/addiction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

aspirate pneumonia

A

strong relationship to alcohol use.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Community-acquired pneumonia (CAP)

A
  • 20% with this condition will require hospitalization
  • 45,000 die annually
  • Pneumovax vaccination
  • Poor living conditions
  • Higher is clients with co-morbid medical conditions such as diabetes who have poor immune system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is tuberculosis

A
  • Not just a bacterial infection of the lungs
  • Other factors:
        • Intensity of exposure
        • Poor health
        • Malnutrition
        • SUD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is tuberculosis transmitted, and how does it kill?

A
  • TB kills by invading the pulmonary system and can also infect virtually every organ in the body
  • transmitted through droplets via sneezing/coughing
  • bacteria can be dormant or become active if immune system low.
  • Clients entering treatments centers for SUD need medical clearance for TB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

symptoms of TB

A
  • productive coughing (mucous, blood)
  • dry cough
  • poor appetite
  • GI symptoms
  • SOB,
  • chest pain
  • flushed face,
  • chronic fever
  • night swears
  • weight loss
  • weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

treatment of TB

A
  • Regimens can take as long as 12-24 months
  • Lifestyle of typical alcohol/drug abusers often makes treatment compliance for TB very difficult
  • Almost 20% of those with Tb also had SUD
  • Remains potentially fatal
  • Mantoux test- Skin test to assess if exposed to TB
  • X-ray and sputum tests to confirm Dx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acquired Immune Deficiency Syndrome (AIDS)

A
  • a constellation of symptoms, most important of which is the destruction of the individual’s immune system
  • HIV destroys CD4 cells of immune system
  • Person can remain asymptomatic before opportunistic infections appear.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does AIDS kill?

A
  • HIV infects the very cells sent out by the body to destroy typical pathogens
  • Can remain asymptomatic for 10+ years
  • In 20% of the cases, the development of an opportunistic disease is the first outward sign of HIV infection
  • In many cases the individual’s death is the result of one of the opportunistic infections
17
Q

The chain of HIV infection

A
  • Male-to-male sex is most common form of transmission in the US (57% of cases)
  • Unprotected heterosexual intercourse is 2nd most common
  • Sharing IV needles (40% of IV drug users are infected with HIV)
  • Less common is “vertical transmission” infection of baby during childbirth
18
Q

Life expectancy for people with HIV-1 infection

A
  • HIV infected person is thought to lose 10 years of potential life
  • Those with HIV and SUD lose approximately 20 years of potential life
19
Q

The treatment of HIV infection

A
  • Nutritional status (IV drug users often have inadequate nutrition)
  • Antiviral therapy
    (Slow, but do not eliminate replication of HIV + High cost)
20
Q

AIDS and suicide

A

Period of greatest risk appears to be the period immediately after the individual learns they are infected

21
Q

RPN role with pt with AIDS

A

Suicidal risk – assess & provide education on how HIV is not a death sentence

22
Q

How frequentlyshould you repeat an HIV test for patients with substance use disorders?

A

every 3-6 months

23
Q

what is usually the first type of infection we see in untreated HIV

A

PCP pneumonia

24
Q

Viral hepatitis “A”

A
  • inflammation of the liver
  • hepatitis “A” virus
  • 5% of cases thought to involve sharing needles
  • 1% of cases develop acute liver failure

-Chronic alcohol use
- Oral fecal transmission
- Vaccine

25
Q

Viral hepatitis “B”

A
  • 100 times as contagious as HIV
  • Can live on surfaces for up to a week
  • Transmitted by toothbrush, razor, IV drug use, sexual contact, even kissing
  • 45-90% of IV drug users are exposed within a year of starting
  • 90-95%recover completely acute live failure in less than 1%
  • 20% will develop cirrhosis
  • Vaccine
26
Q

hepatitis “C”

A
  • 3 million people in the US
  • 45% attributed to IV drug use
  • Slowly destroys liver over 20-30 years
  • Alcohol and/or marijuana users experience increased progression through stages
  • no vaccine
27
Q

true or false: If an individual is found to have a positive hepatitis C antibody, they are infected with hep C

A

false it only indicates a previous exposure to hepatitis C.

28
Q

true or false: 15 - 30% of people initially infected with hepatitis C will spontaneously clear the virus within 6 months without any treatment

A

true

29
Q

true or false: you need a positive hepatitis C antibody test to confirm diagnosis

A

false
- a positive hepatitis C antibody test MUST be followed up with a hepatitis C RNA PCR to confirmactive infection.They will be antibody positive for hepatitis C for life, however, this does not provide protection from re-infection with hepatitis.

30
Q

true or false: there is a cure for hep c

A

true
- A cure is possiblewith the appropriate treatment regimen and all patients are eligible for treatment.

31
Q

true or false: Daily smoking of tobacco or marijuana increases the risk for the development of hepatocellular carcinoma amongst patients with chronic hepatitis C infection

A

true

32
Q

Signs and Symptoms of Hepatitis

A

Fever
Headache
Malaise
GI symptoms
Dark urine
Jaundice
Tender liver
Increased LFT
Self limiting or chronic
Complete resolution to chronic state
Antibodies detected in blood
Fulminant hepatitis (hepatic failure)

33
Q

recommended Vaccinations for SUD clients

A
  • hep A
  • hep B
  • influenza
  • pneumovax 23
  • tetanus & diphtheria
34
Q

Syphilis

A
  • Curable bacterial infection
  • Treponema Pallidum
  • Painless chancre sore on penis and vagina
  • VDRL Labs
  • Teaching/harm reduction
  • Antibiotic treatments
  • Cardiac
  • Ophthalmic
  • Auditory damage
  • CNS infections
  • Regular assessment and screening
35
Q

Gonorrhea

A
  • bacterial infection
  • Neisseria Gonorrhea
  • Urethritis and proctitis
  • Infertility
  • Treatment with antibiotics
  • Regular screening through labs and swabs
  • Center for disease control/Public Health
36
Q

chlamydia

A
  • bacterial infection
  • Chlamydia Trachomatis
  • Urethritis and proctitis
  • Infertility
  • Treatment with antibiotics
  • Regular screening through labs and swabs
  • Center for disease control/Public Health
37
Q

Genital Herpes/Human Papilloma Virus

A
  • Genital herpes type 2 virus
  • Usually asymptomatic
  • Antiviral treatments-acyclovir, valtrex
  • Cervical cancer risk
  • Transmitted via sex
  • HPV vaccine-Gardasil