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Substance Use Disorders Flashcards

(50 cards)

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1
Q

Define pain

A

Unpleasant sensory, emotional experience with actual or potential tissue damage

Personal and subjective experience; patient is the most reliable indicator of pain.

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2
Q

What are the types of pain?

A
  • Acute pain
  • Chronic pain
  • Breakthrough pain

Acute pain results from tissue damage, while chronic pain can be time-limited or last a lifetime.

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3
Q

Differentiate between acute pain and chronic pain.

A

Differs by duration; acute pain is result of tissue damage and chronic pain can last a lifetime

Chronic pain includes conditions like cancer and noncancer types such as peripheral neuropathy and osteoarthritis.

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4
Q

What is breakthrough pain?

A

chronic pain with acute exacerbations

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5
Q

What is nociceptive pain?

A

Physiologic pain resulting from tissue injury (somatic or visceral)

Includes somatic and visceral pain.

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6
Q

What is neuropathic pain?

A

Pathophysiologic pain resulting from damage to the peripheral or central nervous system

May occur in the absence of tissue damage and inflammation.

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7
Q

List the components of pain assessment.

A
  • Self-report
  • Location
  • Intensity
  • Quality
  • Onset and duration
  • Aggravating and relieving factors
  • Effects on function and quality of life

Comfort-function goal is a key aspect of pain assessment.

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8
Q

What are the pain scales used for assessing intensity?

A
  • Numeric Rating Scale (NRS)
  • Visual Analog Scale (VAS)
  • Wong-Baker FACES Pain Rating Scale
  • FLACC
  • Faces Pain Scale-Revised (FPS-R)
  • Verbal Descriptor Scale (VDS)
  • CPOT

Specific scales cater to different populations, including children and patients in critical care.

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9
Q

What is the hierarchy of pain measures for a patient with dementia (or nonverbal)?

A
  • Obtain self report
  • Search for potential causes
  • Observe behavior
  • Proxy reporting
  • Attempt analgesic trial
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10
Q

What is the goal of pain management?

A

Effective and safe analgesia with optimal relief

Comfort function goal is the responsibility of all members of the health care team.

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11
Q

How do opioid analgesics work?

A

Act on the CNS to inhibit activity of ascending nociceptive pathways

This mechanism helps reduce the perception of pain.

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12
Q

How do NSAIDs work?

A

Decrease pain by inhibiting cyclooxygenase (COX), which is an enzyme involved in production of prostaglandins

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13
Q

How do local anesthetics work?

A

Block nerve conduction when applied to nerve fibers

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14
Q

What are the classifications of analgesic agents?

A
  • Nonopioid (Acetaminophen, NSAIDs)
  • Opioid (Mu agonist, agonist–antagonist)

Examples include morphine and buprenorphine.

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15
Q

Fill in the blank: _______ is a common nonopioid analgesic that inhibits COX to relieve pain.

A

Acetaminophen

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16
Q

What are adjunctive agents in pain management?

A
  • Local anesthetics (lidocaine)
  • Anticonvulsants (Gabapentin, pregabalin)
  • Antidepressants (TCAs, SNRIs)
  • Ketamine

These agents can enhance pain relief when used in conjunction with other analgesics.

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17
Q

What are nonpharmacologic methods in pain management?

A
  • Natural products (herbs, botanicals, vitamins, probiotics)
  • Mind and body practices (acupuncture, chiropractic manipulation, massage therapy, yoga, tai chi)
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18
Q

What is opioid tolerance?

A

Decrease in one or more of the effects; Increase usage needed to effect pain relief

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19
Q

What is opioid physical dependence?

A

Normal response with opioid use of 2 weeks or more; manifested by withdrawal symptoms

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20
Q

What is substance use disorder (SUD)?

A

Impaired use of a substance despite major problems, characterized by impaired control, continued use despite harm, and craving

Influenced by genetic, psychosocial, and environmental factors.

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21
Q

List some commonly misused drugs.

Study These Flashcards
A
  • MDMA (Ecstasy)
  • Spice (synthetic cannabinoid)
  • Bath salts
  • Inhalants
  • Cannabis
  • Cocaine
  • Opioids
  • Barbiturates
  • Amphetamines
  • Hallucinogens

Each of these substances has unique effects and potential for abuse.

22
Q

What are some signs of substance use disorder?

Study These Flashcards
A
  • Mood changes
  • Poor hygiene
  • Odd sleep patterns
  • Frequent injuries
  • Relationship difficulties
  • Poor job performance
  • Social Isolation
  • Anorexia

These indicators can help in assessing SUD.

23
Q

What are the gerontologic considerations with opiates?

Study These Flashcards
A
  • Sensitive to sedation
  • Initiate with low dose
  • Increased risk for NSAID-induced GI toxicity
  • Opioid dose reduction by 25-50%
  • Risk for undertreated pain

Risk for undertreated pain exists in older adults.

24
Q

Opiate risk assessment

Study These Flashcards
A
  • Personal or family history of substance abuse
  • Psychological disease
  • Sexual abuse history
25
List common adverse side effects of opiates.
* Sedation * Respiratory depression * Nausea/Vomiting * Hypotension * Constipation * Pruritus (rash) ## Footnote Monitoring and treatment strategies are essential for managing these side effects.
26
Treatment for opiate induced sedation and respiratory depression
* close monitoring, pulse ox, CO2 monitor (capnography) * reduce doses or stop giving * Give reversal agent (Narcan) if severe resp depression
27
Treatment for opiate induced nausea/vomiting
* IV antiemetics: ondansetron * Low dose steroid: dexamethasone
28
Treatment for opiate induced pruritis (rash)
* Dexamethasone or other steroids * Diphenhydramine or other antihistamines
29
Treatment for opiate induced hypotension
* Stop giving! * Give IVF as ordered * Give ephedrine
30
Treatment for opiate induced constipation
* Hydration * Stool softeners * Bowel regimen * Peristalsis stimulation drug (metoclopramide)
31
What is the purpose of a nursing care plan for pain management?
To achieve and maintain the patient’s comfort-function goal ## Footnote Requires a collaborative and evidence-based approach.
32
What is the purpose of managing anxiety related to pain?
To enhance the overall pain management experience and improve patient outcomes.
33
What should be evaluated in pain management strategies?
Effectiveness and appropriateness of the strategies used.
34
In what situations do most SUD patients seek care through the Emergency Department?
* Requesting detox from substance(s) * Having suicidal/homicidal ideations as side effects * Brought in by family/friends for detox * Brought in by EMS for an acute overdose
35
What resources are available for patients seeking help for SUD without overdose?
* Psychological evaluation * In-patient treatment * Drug rehabilitation counseling (voluntary or involuntary)
36
What is the Clinical Opiate Withdrawal Scale (COWS)?
A scale used to assess the severity of opiate withdrawal symptoms.
37
What are some s/s of opiate withdrawal?
* Increased Resting Pulse Rate * Sweating * Restlessness * Dilated pupil size * Bone or Joint aches * Runny nose/tearing * GI Upset * Tremors * Yawning * Anxiety or irritability * Gooseflesh or Goose “bumps”
38
What is Wernicke-Korsakoff Syndrome?
A condition caused by thiamine deficiency, leading to encephalopathy and psychosis ## Footnote Symptoms include vision changes and memory impairment.
39
What are s/s of Wernicke-Korsakoff Syndrome?
* Vision changes * Memory impairment * Dementia
40
What are short-term used of alcohol considerations for older adults?
* Motor Vehicle Accidents * Falls * Drowning
41
What are long-term use of alcohol considerations for older adults?
* HTN * Heart disease * Stroke * Liver Disease * Digestive Issues
42
What does Blood Alcohol Concentration (BAC) measure?
The amount of alcohol in the blood expressed as a percentage (0.08% = 0.08 g of alcohol/100 mL of blood)
43
Assessment for alcohol abuse
* CNS depression * GI distress (gastritis) * Cardiomyopathy * Pancreatitis * Hepatitis * Immunosuppression * Sexual dysfunction
44
S/S of delirium tremens in alcohol withdrawal
* Anxiety * uncontrolled fear * tremor * irritability/agitation * insomnia * incontinence * tachycardia * HTN * dilated pupils * hyperthermia * profuse perspiration * hallucinations
45
What are the medical management steps for a patient with acute alcohol intoxication?
* Assess for head injury * Check for hypoglycemia * Protect airway * Hydrate with isotonic IVFs * Obtain labs
46
What nursing interventions are critical for a patient with acute alcohol intoxication?
* Monitor neurological status * Protect airway * Provide supplemental O2 * Monitor vital signs
47
What is the nursing goal when managing a patient with alcohol intoxication?
To ensure patient safety and comfort while monitoring their condition.
48
What are the medical goals in treating Alcohol Withdrawal Syndrome?
* Obtain history of ETOH use * Manage symptoms * Prevent injury or seizures * Replace lost fluids
49
What should be monitored closely in patients undergoing treatment for Alcohol Withdrawal Syndrome?
* Vital signs * Blood glucose levels * CIWA protocol adherence
50
What does CIWA stand for?
Clinical Institute Withdrawal Assessment for Alcohol.
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