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Med Surg > Addictive Behaviors > Flashcards

Addictive Behaviors Flashcards

1
Q

Substance Abuse (need 3 or more of the following..)

A

Failure to fulfill major role obligations, Recurrent use even when it is hazardous, Recurrent substance-related legal problems, Continued use despite relationship problems

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2
Q

Addiction

A

Primary, chronic, nuerobiologic disease with genetic, psychosocial, and environmental factors. (Loss of control over use, continued use despite knowledge of harmful consequences, compulsion to use, craving)

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3
Q

Dependance

A

Reliance on a substance that has reached the level that absence of it will cause an impairment in function

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4
Q

Dependence..3 or more of the following 12

A

Tolerance, withdrawl, taking in large amount or for longer than intended, Unable to control use, great deal of time spent getting the substance, Using the substance, or recovering from the substance, Important social/recreational activities are given up bc of the substance, Continued use even w/known health or psychological problems caused by the substance

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5
Q

Chantix

A

Gives some nicotine effects but also blocks the effects of nicotine if they resume smoking

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6
Q

Zyban

A

Antidepressant, reduces the urge to smoke, reduces some withdrawal prevents weight gain

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7
Q

Tobacco cessation programs used along with nicotine replacement

A

Hypnosis, acupuncture, behavioral interventions, aversion therapy, group support programs, individual therapy, self-help, coping skills

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8
Q

Tobacco Cessation 5 A’s

A

Ask- Identify all tobacco users at every contact, Advise- strongly urge all tobacco users to quit, Asses- determine willingness to quit, Assist- aid the patient in developing a plan to quit, Arrange- schedule follow up questions

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9
Q

Tobacco Cessation 5 R’s

A

Relevance- ask the patient to tell you why quitting is is personally relevant, Risks- ask the question to identify consequences of tobacco use, Rewards- ask the patient to identify potential benefits of stopping tobacco use, Roadblocks- Ask the patient to identify barriers to quitting smoking, Repetition- repeat process every clinic visit

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10
Q

Benefits of smoking cessation- 20 min

A

BP decreases, HR decreases, body temp of hands/feet increases

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11
Q

Benefits of smoking cessation- 12 hours

A

Carbon Monoxide levels in blood drops to normal, oxygen level increases to normal

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12
Q

Benefits of smoking cessation- 48 hours

A

Nerve endings start regrowing, ability to smell and taste is is enhanced

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13
Q

Benefits of smoking cessation- 2 weeks to 3 months

A

circulation improves, walking becomes easier, lung function increases, coughing/sinus congestion/fatigue/SOB decrease

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14
Q

Benefits of smoking cessation- 1 year

A

risk of heart disease decreases to half that of a smoker

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15
Q

Benefits of smoking cessation- 10-15 years

A

risk of stroke, lung and other cancers, and early death returns to nearly the level of people who have never smoked

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16
Q

How do stimulants work?

A

Work by increasing the amount of dopamine in the brain producing euphoria, alertness, and rapid dependance

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17
Q

Stimulant examples

A

Nicotine, cocaine, amphetamines (can be legal), methamphetamine, ritalin, caffeine

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18
Q

Overdose and stimulants

A

Common, death does occur. Restlessness, paranoia, agitated delerium, confusion, repetitive behaviors, seizures, combative, fever, high HR/BP

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19
Q

Antidote and stimulants

A

No antidote for cocaine and amphetamines

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20
Q

Nursing management for stimulants

A

patent airway, IV access, 12-lead ECG, treat dysrhythmias, treat HTN and tachycardia, give ASA to prevent MI, give valium or Ativan for seizures

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21
Q

Depressants

A

Sedatives, alcohol, hypnotics, opiods

22
Q

Sedative-Hypnotics

A

barbituates, benzodiazepines, barbituate-like drugs

23
Q

Sedative-Hypnotics actions

A

depress the CNS causing sedation at low doses, sleep at high doses. High doses can give an initial euphoria and intoxication, tolerance develops rapidly to the euphoria, but not to the depressant

24
Q

Depressants- Opioids

A

Illegal- heroin Legal- fentanyl, oxycodone, demerol, vicodin, morphine, codeine

25
Q

Opioid action

A

causes CNS depression and major effect on the brain reward system. Usually injected IV so increased risk of diseases

26
Q

Depressants overdose symptoms

A

Overdose causes death from resp depression/arret, also causes n/v, slurred speech, confusion, drowsiness, low HR, low BP, low RR

27
Q

Depressant overdose nurse management

A

Need serum and urine drug screens, priority is ABC’s, continuous monitoring, ensure patent airway, IV access, 12-lead ECG, drug levels, give antidotes, gastric lavage, activated charcoal. Shouldnt be released until seen by psychiatric professional

28
Q

Antidote for bexodiazipines

A

Flumazenil. Can cause seizures in pts w/physical dependance, dose may need to be repeated

29
Q

Barbituates

A

No antidote, may need dialysis, gastric lavage or charcoal can be given if less than 4-6 hours

30
Q

Antidote for Opioids

A

Antidote is naloxone (narcan), dose may need to be repeated

31
Q

S/S of opioid withdrawal and TX

A

S/S- craving, abdominal cramps, diarrhea, n/v, sweating
TX- symptom based and doesnt always require medications

Withdrawal is uncomfortable but not life threatening. Methadone is decreasing doses can decrease SX

32
Q

Methadone

A

Very long half life so people overdose easily bc dont get relief right away

33
Q

How does Methadone work?

A

Blocks the “high” caused by using opiates (does not cause euphoria or intoxication). It produces stable levels of the drug in the brain so the patient doesnt get a rush and feels less desire to use opioids.

34
Q

What should not be used when taking Methadone?

A

Alcohol, it causes some depressant effects

35
Q

When is methadone used? How often and where?

A

Sometimes used to treat chronic pain. only taken once per day and usually in a supervised setting

36
Q

Alcohol dependance

A

Dependance generally occurs over a period of years. It is a chronic, progressive, potentially fatal disease. it affects almost all cells in the body, particulary the CNS

37
Q

Will women or men have higher blood alcohol levels?

A

women, even with same intake

38
Q

Blood alcohol levels.. 0.02,0.06, 0.08, 0.1, 0.3, 0.45

A
  1. 02- reached after one drink, light drinkers will feel an effect
  2. 06- judgement is mildly impaired
  3. 08- judgement is clearly impaired, legal intoxication in some states
  4. 1- legally intoxicated in most states
  5. 3- usually lose consciousness
  6. 45- stop breathing
39
Q

When does alcohol intoxication occur?

A

After binge drinking or using alcohol w/CNS depressants causing respiratory and circulatory failure

40
Q

nursing actions for alcohol intoxicatioin

A

Maintain ABC’s until detox is complete and alcohol is metabolized. Closely monitor VS and LOC. Administer IV thiamine (first) then IV glucose. Watch for hypoglycemia, low magnesium levels. Stay with the patient, expect agitation and anxiety. Assess for injury. Continue assessment and intervention until BAC is 0.10

41
Q

Is there an antidote for alcohol?

A

No..DO NOT give stimulates or depressants

42
Q

Alcohol withdrawal syndrome

A

May occur 4-6 hours after last drink and continue for 3-5 days.
Minor- anxiety, increase BP/HR, sweating, nausea, hyperreflexia, insomnia
Major- visual/auditory hallucinations, tremors, seizures, delerium

43
Q

Alcohol withdrawal delerium

A

disorientation, visual/auditory hallucinations, hyperactivity, death from hyperthermia, peripheral vascular collapse, cardiac failure

44
Q

Nursing actions for AWS

A

Give benzodiazepines, Tegretol or Dilantin to prevent seaizures, antipsychotics if benzo’s dont work; also thiamine, folic acid, magnesium sulfate if needed. Keep patient in a quiet, calm environment and do not restrain

45
Q

Cannabis high and low dosage effects

A

Low- produces less effects than alcohol
High- causes euphoria, sedation, hallucinations

mostly causes problems in the brain, CV, resp systems

46
Q

Opiate Withdrawal SX

A

sweating, diarrhea, watery eyes, n/v, abd cramps. Nursing priority is to tx symptoms, may need meds

47
Q

Sedative/hypnotics withdrawal

A

High HR, seizures, delerium, tremors, hallucinations 9can be life threatening). nursing priority is close observation, valium to start taper

48
Q

Depressant overdose

A

pinpoint pupils, slow RR, shallow resp, sedation. Priority is antidotes (narcan, flumazenil), support breathing, may need gastric lavage, characoal or dialysis

49
Q

Stimulant overdose

A

High HR/BP, chest pain, agitation, fever, pupil dilation. Priority is VS, ECG, 02-can die if dysrhythmias or MI

50
Q

Nursing interventions: Operative patients

A

increased risk of post-op complications and death, standard amounts of anesthetics/analgesics may not be sufficient, anesthetics may have prolonged sedative effect if the liver is damaged. Withdrawal symptoms may be delayed several days b/c of anesthetics. Postpone surgery if BAC is greater than 0.2

51
Q

Gerontologic Considersations

A

HCPs are much less likely to recognize substance problems in older adults. Misuse or abuse of psychoactive drugs agents can cause delirium, confusion, memory loss, nueromuscular impairment. Decreased circulation, so they can become intoxicated at much lower levels. Screening questionnaires are not useful unless specific to geriatrics.

Med Surg (9 decks)

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