Substance-Related or Addictive Disorder Unit 3 (2) Flashcards Preview

Semester Three - Half One - Nursing 211 > Substance-Related or Addictive Disorder Unit 3 (2) > Flashcards

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1

Groups at Risk for Substance Abuse

  • Teenagers
  • Psychiatric Clients
  • Women
  • Hospital Clients
  • Elderly
  • Health Care Providers

2

Which basic needs are affected by substance abuse?

  1. Physical needs
  2. Safety  and Security
  3. Love and belonging
  4. Self Esteem

3

CAGE Assessment

  • Cut down? (has anyone asked you to cut down use)
  • Annoyed you? (has anyone annoyed you by asking about your use)
  • Guilty? (do you feel guilty about your use)
  • Eye opener? (have you ever did something that made you think you have a problem)

4

Assessment

  1. Which drug is being used
  2. Signs of intoxication, overdose, and withdrawal
  3. Assess basic and higher level needs
  4. Assess body systems affected by chronic alcohol or other substance use
  5. Assess client's ability to meet own needs

5

Reasons for Relapse

  • Cravings
  • Brain neurotransmitters are depleted, which causes cravings
  • Can take several weeks for the brain to start making neurotransmitters
  • Motivation forchange
  • Family dynamics
  • Some substances can be stored in the brain for several weeks (THC)

6

Defense mechanisms used by substance users

  1. Denial: deny that they have a problem or minimize the consequences
  2. Projection: project or blame their difficulties on others,especially a spouse
  3. Rationalization: Making excuses for using substances. Also stating, "I know I shouldn't but my life is awful."

7

Behaviors associated with substance users

  1. A means for clients getting what they want
  2. Progressive worsening of lifestyle/choices overtime
  3. Conning/Manipulating: Abusers con themselves first
  4. Bargaining: "I'll just use a little and then stop"
  5. Feigning: injury or illness to get to drugs

8

Acute Detoxification CarePlan

  1. Provide a safe and supportive environment
  2. Life-threatening physiological symptoms are attended to first
  3. WIthdrawal protocols: CIWAA, COWS
  4. Monitor VS and withdrawal symptoms
  5. Assess thinking and perceptions
  6. Apply ice packs for fever
  7. Decrease stimulation, provide a darkened quiet room
  8. Point out reality
  9. Provide adequate nutrition, fluids, hygiene and elimination
  10. Assess LOC
  11. Monitor I&O
  12. Promote Skin Integrity
  13. Maintain non-judgmental, positive attitude
  14. Offer emotional support and encouragement to the client and his or her family
  15. Provide accurate information, education and assistance during the course of detoxification treatment to client and family
  16. Provide explanations for physical symptoms
  17. Refer client to community resources for recovery program

9

Substitution Therapy

  1. Ativan
  2. Librium
  3. Naloxone/Narcan
  4. Methadone

10

Ativan

 

Helpful in controlling anxiety and agitation. Offers symptom relief from alcohol withdrawal

11

Librium

Longer acting than Ativan with same effects

12

Naloxone/Narcan

For the treatment of alcohol dependence, heroin abuse, opioid intoxication

13

Methadone

  • Long acting (24-36 hours)
  • Safe, synthetic opioid that is administered as a daily dose
  • Works on the same receptors in the brain that produce the feelings of pleasure when heroin and opiates bind to them but it does not produce the narcotic high.
  • Methadone is addictive
  • Alleviates the cravings for opiates

14

Methadone Detoxification

  1. Clients recieve methadone for 3-5 days in decreasing doses
  2. Withdrawal symptoms often appear
  3. Clonidine (Catapres) is begun and given inincreasing doses until withdrawal symptoms are alleviated
  4. Clonidine blocksthe withdrawal symptoms, making the detox process less painful and more rapid than with methadone alone. The client feels less anxious and depressed.
  5. Methadone is eventually discontinued

15

Methadone Maintenance

  1. The majority of individuals withdrawing from methadone return to opiate use within one year.
  2. Federal regulations allow methadone maintenancein licensed facilities to last as long as needed

16

Suboxone

First synthetic opiod medication approved for the treatment of opiod dependence in an office-based setting

17

Suboxone Facts

  1. Can be taken home
  2. Buprenorphin HCL and naloxone HCL, administered sublingually
  3. Buprenorphin when placed under the tongue decreases the symptoms of opiod withdrawal
  4. Little naloxone is absorbed under the tongue
  5. If suboxone is injected, naloxone will cause a person dependant on an opiod to quickly go into withdrawal thus preventing people from abusing the medication