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NCLEX: Mark Klimek Lectures > Alcohol > Flashcards

Alcohol Flashcards

1
Q

what is the #1 issue with abuse? how do you treat it?

A
  • denial
  • treat with confronting (point out the difference between what they think and what they do)
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2
Q

what type of denial should not be treated with confrontation? how should it be treated?

A
  • denial r/t loss & grief
  • tx: support it
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3
Q

define: dependency r/t abuse

A
  • abuser gets SO to do things for them, abuser is dependent on SO
    ex. call my boss for me
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4
Q

define: codependency r/t abuse

A
  • SO derives positive self esteem by doing things or making decisions for the abuser

ex. “I’m a wonderful SO for calling their boss for them”

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5
Q

what is the treatment for dependency/co-dependency

A
  • set limits & boundaries –> teach the SO to say “no”
  • increase self-esteem of SO
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6
Q

define: manipulation

A
  • when the abuser gets the SO to do things for them that aren’t in the SO’s best interest
  • the nature of the act is dangerous or harmful
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7
Q

what is the key difference between dependency/co-dependency and manipulation

A
  • dependency = neutral acts
  • manipulation = harmful to SO & SO doesn’t get + self esteem from it
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8
Q

ex. an alcoholic parent asks their 17 year old daughter to go buy alcohol from them

ex. an alcoholic person asks their 59 year old SO to go buy their alcohol from them

A
  1. manipulation (illegal for a 17yo to buy alcohol for them)
  2. dependency
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9
Q

what is treatment for manipulation

A
  • set limits & enforce “no”
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10
Q

what is wernicke’s and korsakoff

A
  • wernicke’s = encephalopathy
  • korsakoff = psychosis
  • often occur together, but two separate things
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11
Q

what is wernicke’s and korsakoff induced by?

A
  • vitamin B1 or thiamin deficiency
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12
Q

what are symptoms of wernicke’s and korsakoff

A
  • loss of touch w reality
  • amnesia (++ memory loss)
  • confabulation (make up stories & believe its their reality)
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13
Q

what is treatment for wernicke’s and korsakoff

A
  • redirect –> rechannel what they want but cannot do, into something they can

ex. the pt believes they need to go to the white house for work, rechannel it into watching the news on what’s happening in the whitehouse

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14
Q

what is a “bad way” to treat wernicke’s and korsakoff

A
  • confront
  • agree/disagree
  • do not present reality, bc they can’t learn it
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15
Q

what are 3 characteristics of wernicke’s and korsakoff

A
  • preventable
  • arrestable
  • irreversible
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16
Q

how can wernicke’s and korsakoff be preventable and arrestable

A
  • taking vitamin B1
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17
Q

what is a type of aversion therapy for alcoholism

A
  • disulfuram (antabuse)
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18
Q

how does disulfaram work?

A
  • makes you ++ sick when you consume alcohol
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19
Q

what is the onset of disulfaram

A
  • 2 weeks
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20
Q

what pt teaching should be provided r/t disulfaram

A
  • avoid all forms of alcohol to avoid NV & sickness
  • what has alcohol
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21
Q

what items should you teach pts on disulfaram to avoid

A
  • mouthwash
  • bug spray
  • after shave
  • perfume, cologne
  • OTC meds that end in ___elixir
  • alcohol based hand sanitizer
  • uncooked icings (bc of vanilla)
  • NOT red wine vinegar
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22
Q

every abused drug is either an…

A
  • upper or down
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23
Q

what are the 5 upper abused drugs

A
  • caffeine
  • cocaine
  • PSP/LSD
  • adderol
  • methamphetamines
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24
Q

what are S&S of pt’s using “upper” drugs

A

(everything goes up)
- euphoria
- restlessness
- irritable
- tachycardia
- diarrhea, borborygmi
- hyperreflexia (+3,+4)
- spastic
- resp. seizu
- seizure
- increased temp

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25
Q

what are examples of “downer” drugs

A
  • anything thats not an upper

ex. dilaudid, morphine sulfate, fentanyl, ativan, barbs, alcohol, marijuana, etc.

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26
Q

what are S&S of “downer” drugs

A
  • lethargic, difficult to arouse
  • resp depression & resp arrest
  • everything goes down
27
Q

if a pt is ODing on an “upper” drug, what signs would you see? withdrawal?

A
  • OD = everything up
  • WD = everything down
28
Q

if a pt is ODing on a “downer” drug, what signs would you see? withdrawal?

A
  • OD = everything down
  • WD = everything up
29
Q

what is the #1 concern with a downer OD and an upper WD

A
  • resp depression and arrest
30
Q

what is the #1 concern with an upper OD and a down WD

A
  • seizures
31
Q

at birth or within the first 24 hours of birth, you should assume…

A
  • intoxication
32
Q

after 24 hours of birth, what do you assume?

A
  • withdrawal
33
Q

ex. you’re caring for a pt to a downer drug addicted mom 24 hrs after birth. what S&S would you expect to see?

A
  • difficult to console
  • increased startle reflex
  • seizure risk
34
Q

alcohol WD occurs when?

A
  • in about 24 hr after stopping drinking
35
Q

every alcoholic goes through _____, but only a minority goes through…

A
  • every alcohol goes through WD
  • minority go through delirium tremens
36
Q

delirium tremens (DT) occurs when?

A

~72 hrs after drinking

37
Q

alcohol withdrawal syndrome (AWS) always preceeds DT, but…

A
  • DT does not always follow AWS

= if you have DT, you had AWS. but if you have AWS, doesn’t mean you’ll get DT

38
Q

describe the severity between AWS and DT

A
  • AWS: not life threatening
  • DT: life threatening
39
Q

describe the danger associated with AWS vs DT

A
  • AWS: not a danger to self or others
  • DT: danger to self & others
40
Q

describe the difference in diet when caring for a pt with AWS vs DT

A
  • AWS: regular diet
  • DT: NPO or clear liquids (d/t seizure risk)
41
Q

describe the difference in pt’s room when caring for a pt with AWS vs DT

A
  • AWS: semi-private, anywhere
  • DT: private & near nurses station (d/t danger to self & others)
42
Q

describe the difference in mobility when caring for a pt with AWS vs DT

A
  • AWS: regular
  • DT: restricted bed rest
43
Q

describe the difference in restraints when caring for a pt with AWS vs DT

A
  • AWS: none
  • DT: vest or 2 point (one arm & one leg opposite to the other)
44
Q

what meds are used in the treatment of both AWS and DT

A
  • antihypertensives (bc everything is up in withdrawal)
  • tranquilizer
  • multi vitamin with B1 (prevents wernicke and korsakoff)
45
Q

what are aminoglycides

A
  • powerful abx used for treating serious, life threatening, resistant, and gram (-) infections
46
Q

all aminoglycides end in _______

A

_____mycin

47
Q

what 3 drugs that end in mycin are not aminoglycides

A
  • erythromycin
  • zithromycin
  • clarithromycin

(all end in ____thromycin)

48
Q

what are 3 toxic effects of aminoglycides

A
  • ototoxic
  • nephrotoxic
  • toxic to cranial nerve 8 (ear nerve)
49
Q

what should be monitored with aminoglycides r/t ototoxic

A
  • hearing
  • tinnitus (ringing ears)
  • dizziness/vertigo
50
Q

what should be monitored with aminoglycides r/t nephrotoxic

A
  • creatinine (24 hr is first choice, then serum Cr)
51
Q

aminoglycides are given how often?

A

q8h

52
Q

what route are aminoglycides given?

A
  • IM or IV
53
Q

why arent aminoglycides given PO?

A
  • not absorbed = wouldn’t do anything
54
Q

what function does given aminoglycides PO have?

A
  • sterilizes the bowel
55
Q

in what 2 situations are aminoglycides given PO?

A
  • hepaticencephalopathy
  • pre-op bowel surgery
56
Q

what two aminoglycides are given PO?

A
  • neomycin
  • canamycin

(think: who can sterilize my bowel? neo can!)

57
Q

in what situations is it important to draw trough and peaks?

A
  • in meds with narrow therapeutic index
58
Q

trough and peak draw times are based on?

A
  • route, not drug
59
Q

what are the trough draw times for all routes of med admin

A
  • 30 min before next dose
60
Q

what is the peak draw time for subling.

A

5-10 min after drug dissolved

61
Q

what is the peak draw time for IV

A

15-30 min after drug finished

62
Q

what is the peak draw time for IM

A
  • 30-60 min after giving med
63
Q
A

NCLEX: Mark Klimek Lectures (20 decks)

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