Final Exam Flashcards
(116 cards)
1
Q
Most common stimulant
A
Meth
2
Q
Signs of intoxication of stimulants
A
Pupil dilation, paranoia, ammonia smell
3
Q
Withdrawal for stimulants
A
Suicidal ideation due to impulsiveness
4
Q
Why are opioids the most common addiction
A
Easy access
5
Q
Signs of overdose of opioids
A
Shallow breathing, respiratory arrest, change in consciousness
6
Q
Withdrawal of opioids
A
N/V, muscle aches, runny nose, watery eyes, sweating, fever
7
Q
Withdrawal symptoms look like the flu for what drug
A
Opioids
8
Q
What type of opioid is most common to be addicted to? (Heroin or pain pills)
A
Pain pills
9
Q
Why is there a high abuse potential for alcohol?
A
It is legal
10
Q
Withdrawal of alcohol
A
Tremors, sweating, elevated BP
11
Q
When does withdrawal start for alcohol?
A
4-12 hours after last drink
12
Q
When can withdrawal of alcohol progress to delirium tremens?
A
Day 2-3
13
Q
Why might patients going through withdrawal try to manipulate you?
A
They have a control problem
14
Q
Where should you put patients experiencing DT’s?
A
In a quiet area
15
Q
What should you do when assessing patients coping skills?
A
Find out what worked in the past
16
Q
What is the only drug that the withdrawal can directly kill you?
A
Alcohol
17
Q
What is the key symptom to watch for when withdrawing from alcohol?
A
Hallucinations
Means its progressing to DT’s
Emergency!
18
Q
What should you do if you think a coworker has a substance use disorder?
A
Must report it
19
Q
What happens to coworker if they get reported for substance use?
A
Won’t lose license, they just have to complete rehab treatment before returning to work
20
Q
What is most important when suspecting substance use in a coworker?
A
Keep the coworker anonymous
21
Q
When dealing with someone with substance use disorder always…
A
Be empathetic
Set firm limits
Be consistent
22
Q
Therapeutic communication: what NOT to do
A
Agree or disagree
Ask why
Give advice
23
Q
Addiction
A
When the use of a substance interferes with fulfilling role obligations at work, school, or home
24
Q
Assessment tools for withdraw
A
Clinical institute withdrawal assessment
CAGE questionnaire
25
CAGE
Cut: have you ever felt you should cut down on your drinking
Annoyed: have people ever annoyed you by criticizing your drinking
Guilt: have you ever felt bad or guilty about your drinking
Eye-opener: have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover
26
Wernicke's encephalopathy
Deficiency in vitamin B and thiamine
27
How can thiamine replacement be given?
IV or IM
28
Wernicke's leads to...
Korsakoff syndrome: irreversible
| Wernicke's: reversible
29
Alcohol withdraw should be treated with?
Ativan
30
Methadone
Cheapest
Mimic effects of opioid
Causes slight high
Some people stay on it forever
31
What might be a side effect of methadone
QT syndrome
| Must get EKG to start
32
What is cheaper? Methadone or suboxone
Methadone
33
Suboxone
Less addictive
| Less risk of overdose
34
Vivitrol
Used as once monthly injection for opioid withdrawal
| Can also be used to stop alcohol cravings
35
Revia (naltrexone)
Used as once daily pill for opioid withdrawal or to stop alcohol cravings
36
Ativan
Acute withdrawal of alcohol
Very addictive
Works instantly
37
Antabuse
Blocks enzyme that metabolizes alcohol
38
Why is education important for antabuse?
Can't use any products with alcohol in it because it will be absorbed through the skin and can cause side effects such as vomiting
39
Librium
Used after ativan
40
Serax
Works like ativan and librium
| Cannot be processed in liver
41
Who are people often abused by?
Someone they know
42
Victim profile
```
Often accepts blame
Low self esteem
Feels guilty
Anger, fear, shame
Isolated from family and friends
```
43
Victimizer profile
```
Low self esteem
Jealous
Poor coping skills
Dual personality
Sees others as possessions
Threatened by signs of independence
Controlling
```
44
Honeymoon phase of abuse
Abuser may show jealousy
| No abuse taking place
45
Tension building phase of abuse
Minor incidents occur such as criticizing, yelling, and blaming
Victim is "walking on eggshells"
Victim tries to prevent violence
46
Explosive phase of abuse
Tension released and typically gets worse over time
Victim will be hurt and may go to hospital
Police may be called
47
Reconciliation phase of abuse
Abuser apologizes and begs the victim to believe the violence won't happen again
Blames the victim for the abuse
48
Why don't the victims of abuse leave?
```
Fear of losing custody
Fear for family members including children
Fear of retaliation
Physical or financial dependence
Lack of support network
```
49
Homicide of the victim of abuse or homicide-suicide
74% of all murder-suicides involved intimate partners
50
Risk factors that the violence will escalate
Guns in the home (5-8 more likely)
Battering during pregnancy
Extreme jealousy/control
Substance abuse
51
When is the most dangerous period for abuse?
After the victim leaves
52
Sexual assault has to do with...
Has nothing to do with sex and everything to do with power, control, and humiliation
53
Rape
Penetration of vagina, anus, or oral penetration by a sex organ of another person
54
Sexual assault
Any type of sexual contact or behavior that occurs without consent
(Sex, child molestation, incest, fondling, attempted rape)
55
Expressed response pattern of rape
```
Fear
Anxiety
Anger
Crying
Tension
```
56
Controlled response pattern for rape
Masked or hidden feelings
| Calm and composed
57
Compounded rape reaction
Additional symptoms such as depression, suicide, psychotic behavior
58
Silent rape reaction
Tells no one
Burden may be unbearable
Unresolved feeling may manifest in other sexual crisis
59
Sexual assault is usually done by...
Someone you know
60
Why don't people seek care after rape?
```
Fear of having to report
Not wanting someone to touch you
Fear of court
Not wanting to admit it to yourself
Fear of pain
```
61
What is the most common form of child abuse?
Neglect
62
Physical abuse
Non accidental physical injury ranging from minor injury to death
63
Physical signs of abuse
Wounds in different healing stages
Old scars
Poor skin turgor
Growth patterns
64
Emotional abuse of a child
Pattern of behavior from caretaker resulting in serious impairment of child's social, emotional or intellectual functioning
65
Neglect of child
Can be physical or emotional
66
Physical neglect
Refusal or delay in health care, abandonment, inadequate supervision
67
Emotional neglect
Chronic failure to provide hope, love, and support needed for healthy personality
68
Sexual abuse of a child
Employment, use, persuasion, inducement, enticement, coercion of child to engage in sexually explicit conduct
69
S/S emotional abuse of child
Extremes in behavior
Innapropriately adult or infantile behavior
Delays in physical or emotional development
70
S/S neglect of children
```
Dirty
Lacks medical/ dental care
Begs or steals food or money
Abuses alcohol or drugs
Not dressed for weather
```
71
S/S of sexual abuse of child
```
Not changing for gym
Nightmares or bedwetting
Sudden change in appetite
Bizarre or unusual sexual knowledge or behavior
Runs away
Attachment issues
```
72
Physical signs of sexual abuse in child
Erosion of hymen
Reflex anal dilation
Petechiae to pharynx
Soft tissue ecchymosis to thighs
73
S/S of child abuse offenders
Limits contact with others and overly protective of child
Often victims in early life and have impaired attachment with own child
Jealous and controlling
Secretive and isolated
74
Is non-sexually abusing parent usually aware of the incest occuring?
Yes
| Fear or relief may be present
75
Intellectual disability disorder (IDD)
Onset during developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains
76
Mild IDD
IQ 50-70
77
Moderate IDD
IQ 35-49
78
Severe IDD
IQ 20-34
79
Profound IDD
IQ <20
80
What is the main tool to assess IDD
Functional assessment
81
Autism spectrum disorder distinguishing features
Early onset
Severe social unrelatedness
Evaluated on a spectrum
82
Clinical features of autism spectrum disorder
Self stimulating
Impaired communication
Stereotypic behavior
Poor social interactions
83
S/S of autism spectrum disorder
```
Tantrums
Communication issues (delay, lack of eye contact)
Repetitive hand movements
Toe walking
Developmental delays (toilet training)
Humming
Hypersensitivity to noises and textures
Interests/fixated on things that don't move
Difficulty verbalizing needs
```
84
Priority for safety for autism spectrum disorder
Running off
| Do not have the same sensation for pain- hard to recognize when they are in pain
85
Asburgers
Highly intelligent
Usually have one aspect they really excel at
Missing other social cues
86
Medications for autism spectrum disorder
```
Risperdine
Tenex
Clonidine
Propranolol
Arpiprozole
```
87
ADHD diagnosis
Should not be diagnosed before age 5 - some of this is normal for a child
When diagnosed early, cardiac development is still occurring and being put on a stimulant can disrupt this
88
S/S of ADHD
```
Motor restlessness
Difficulty concentrating
Trouble sitting still
Acting out behaviors r/t frustration
Impulsivity
```
89
Medications for ADHD
```
Stimulants:
Ritalin
Concerta ER
Adderall
Focalin
Vyvance
Quillevent SR
```
90
Non stimulants for ADHD
Straterra
| Intuniv (similar to tenex)
91
Side effects of ADHD meds
Motor ticks
Loss of appetite
Weight loss
Can sometimes have an opposite effect of what is intended
92
Nursing interventions for ADHD meds
Often recommended to take a break from these meds
Do not give after 4pm
Take meds with meals
93
Tourette's disorder
Most severe tic disorder
| Can diminish with aging
94
Meds for tourette's
Haldol
Clonidine
Tenex
95
Oppositional defiant disorder
Occurs early in development
Trouble with authority figures
Defiant
96
Intermittent explosive disorder
Unprovoked go into fits of rage
97
Conduct disorder
```
Reckless behavior, disregard for social norms
Common to turn into antisocial disorder
More boys than girls - older
No guilt or remorse
Manipulation
Theft, vandalism, truancy, running away
```
98
Why are children with conduct disorder impulsive and do not recognize consequences?
Adolescent brain is not fully developed
99
Treatment for conduct disorder
CBT
Mood stabilizers
Tenex
Clonidine
100
Separation anxiety disorder
Develops after a significant loss
| Can include PTSD
101
S/S of separation anxiety
```
Nightmares
Irritability
Reenactment of the event
Regression
Withdrawal
Trouble concentrating
```
102
Disruptive Mood Dysregulation Disorder (DMDD)
Previously bipolar disorder
103
DMDD features
Child will mask depression with things like irritability and refusal to go to school
Somatic complaints
Grades falling
Weight loss
104
Meds for DMDD
Tegretol
| Prozac
105
Schizophrenia
Rarely diagnosed before age 13
| Will usually see odd behaviors early on
106
When is the first psychotic break for schizophrenia?
Adolescence or early adulthood due to increase and changes in gray matter in the brain
107
Meds for schizophrenia
Clozaril
108
Why is lorazepam (ativan) the drug of choice for alcohol withdrawal?
Minimizes risk for seizures
109
Distinguishing feature for alcohol withdrawal
Diaphoresis
110
Common sign of depression in small children
Irritability or refusal to go to school
111
Separation anxiety could be a sign of what in children?
Abuse
112
Who is at highest risk for suicide during withdrawal?
Cocaine abusers
113
Nursing implications for Tenex (for DMDD)
Take BP because drug drops BP
114
What drug makes breath smell like ammonia?
Meth
115
A care plan for a child with autism includes:
Consistency
Structure
Frequent redirection
116
A patient wants to stop taking venlafaxine (effexor) because of the side effects. What do you do first?
Reassure him that side effects are transient and can be treated
