Broadway doesn't go for BOOze and DOPE! Flashcards Preview

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Flashcards in Broadway doesn't go for BOOze and DOPE! Deck (27):
1

Substance Abuse – or chemical dependency
*
use of a substance(s) in an
UC-PHM

use of a substance(s) in an uncontrolled, compulsive, and potentially harmful manner

2

Criteria for diagnosis of substance abuse includes a
maladaptive pattern of substance use during a 12 month period that results in impairment of at least one of the following:
LOLR

- Lack of fulfillment of role obligations
- Ongoing interpersonal problems as a result of or exacerbated by use
- Legal problems
- Risk of physical danger because of use

3

Physical dependency
refers to?
is accompanied by?

Refers to development of a withdrawal syndrome
following abrupt cessation
*
Accompanied by tolerance to a substance – increasing dosage is req to sustain same effects

4

Addiction is characterized by (3)

psychological dependence and preoccupation
with obtaining or using a substance
*
loss of control over the use of a substance
*
continued use despite adverse consequences.

5

How people with substance abuse problems have
other mental health problems.

 6 out of 10

6

Patients with mood disorders and anxiety disorders
are how much more likely to have substance abuse problems and vise versa.

Twice as likely

7

Screening Tools for Identification of
Substance Abuse in the Older Adult
REMEMBER!!!

– A complete comprehensive assessment is important.
Patient history and medical record contribute to the picture – often overlooked….

8

Screening Tools for Identification of
Substance Abuse in the Older Adult
*
CAGE Questionnaire

1. Have you ever felt you should Cut down on your drinking?
2. Have people Annoyed you by criticizing your drinking?
3. Have you ever felt bad or Guilty about your drinking?
4. Have you ever had an Eye opener (drink) first thing in the morning to steady your nerves?

9

Screening Tools for Identification of
Substance Abuse in the Older Adult
*
Second test mentioned + how does it work?

Michigan Alcoholism Screening Test – Geriatric – 24 questions - 5 or more yes answers are positive –

10

Shortened MAST protocol?

Shortened MAST – 10 questions – 2 or more yes answers are positive, focus is alcohol,
not drug abuses.

11

When should screening be considered?

If the older adult is going through life transitions, such as retirement, taking on caregiver role, or death of a spouse.

12

What should prompt screening?

Physical signs should prompt screening –

13

Examples of physical signs that should prompt screening.
SAD BUG FIN

Look for how many of these cues?

Sleep complaints
Anxiety
Depression

Bruising
Unexplained physical complaints
Gait disturbance

Frequent falls
Irritability persistent
Neglect of hygiene

All have been identified as clues to substance abuse. Look for several, not just one….

14

Just a bunch of Frannyisms
Be...
Engage from...
Seek...
Do...

Be respectful and non-judgmental
Engage from concern
Seek to understand the individual.

15

As often as we miss the cues, we...

hypothesize incorrectly!

16

When does late onset alcohol abuse occur?

After 60

17

Late Onset Alcohol Abuse occurs as a result of

the stress of aging and related situations

18

Late Onset Alcohol Abuse occurs as a result of the stress of aging and related situations, such as?
L L–3 RR

Loneliness and isolation
Loss
– social/emotional support
– sensory capabilities
– full mobility
Reactive depression
Reduced ability of aging body to handle alcohol

19

Elderly recovery rate from alcohol abuse

75%

20

System changes (aging plus alcohol): (5)
NG RIM

Neurological – memory loss
GI – gastritis, cirrhosis
Renal and pharmacokinetics
Immune – increased infx
Musculoskeletal – muscle atrophy

21

Pharmacological agents used in conjunction with an
overall program of couselling support, self-help groups, and medical monitoring.

Benzodiazepines – shorter acting used for alcohol
withdrawal (lorazipam, oxazipam) 1/2 to 1/3 dosage
Antismoking Medications
Antibuse

22

Alcohol detoxification and older adults?

riskier

23

Alcohol detoxification minor withdrawal?

6-12 hours

24

Alcohol detoxification major withdrawal?

10-72 hours

25

S/S of alcohol detox? (4)

vomiting, diaphorisis, hallucinations, seizures

26

When may delirium tremens occur?

24-72 hours up to 10 days after last drink

27

Nursing Interventions
to Address Substance Abuse

Be adept at assessment, recognition, intervention, and referral
*
Facilitate safe arena for discussion
Blend of compassion/respect
Build therapeutic r'ship
*
Initiate health promotion to improve QOL
*
Assess safety/suicide thoughts/plans
Focus on psychosocial aspects in recovery, education, quality of life, social supports such as AA or Alanon.