T2-Substance-Related Addictive Disorders Pt. 1 Flashcards Preview

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Flashcards in T2-Substance-Related Addictive Disorders Pt. 1 Deck (50):
1

A physical or psychological dependence on a substance

Addiction

2

*What is the most common ego defense mechanism?

Denial

3

The state in which a person's mental and physical abilities are impaired by alcohol or another substance

Intoxication

4

What is the blood alcohol level if a person is intoxicated?

100-200 mg/dL

5

The discomfort and distress that follow discontinuing the use of an addictive drug

Withdrawl

6

When does withdrawal occur?

Within 4-12 hours of cessation in heavy or prolonged alcohol use

7

*When would you expect alcohol withdrawal to occur?

Within 4-12 hours of cessation in heavy or prolonged alcohol use; or reduction in heavy or prolonged alcohol use

8

What must we ask when talking to a patient about withdrawal?

1. "When was your last drink?"
2. "What did you drink?"
3. "How much did you drink?"

9

Peripheral neuropathy is a complication of chronic alcohol abuse. Peripheral neuropathy is characterized by peripheral _____ that results in pain, burning, tingling, or prickly sensations of the extremities.

*What does peripheral neuropathy result from? Is it reversible?

Characterized by peripheral nerve damage

Results from= Vit. B deficiency (THIAMINE); it is reversible with abstinence from alcohol and restoration of nutritional deficiencies

10

Alcoholic myopathy is a complication of chronic alcohol abuse. Is alcoholic myopathy acute or chronic?

Can be either

11

What happens in ACUTE alcoholic myopathy (a complication of alcohol abuse)?

-Sudden onset of muscle pain, swelling, and weakness
-Reddish tinge in urine cause by myoglobin
-Breakdown of muscle excreted in urine
-Rapid rise in muscle enzymes in blood
-Elevations in CPK, lactate, LDH, aldolase, AST

12

What happens in CHRONIC alcoholic myopathy (a complication of alcohol abuse)?

-Gradual wasting and weakness in skeletal muscles
-NO PAIN OR TENDERNESS OR ELEVATED MUSCLE EZYMES LIKE WITH ACUTE

13

What is alcoholic myopathy a result of? Is it reversible?

Thought to be a result of the same Vit B defiance as peripheral neuropathy

Improves with abstinence and return to nutritious diet

14

*What is the most serious form of thiamine deficiency in alcoholics?

Wernicke's Encephalopathy

15

What happens in Wernicke's encephalopathy (complication of chronic alcohol abuses)? How serious is this disease?

Paralysis of eye muscles, double vision, ataxia, somnolence, stupor

DEATH will result if thiamine replacement therapy is not undertaken QUICKLY

16

A complication of alcohol abuse: a syndrome of confusion, loss of recent memory, confabulation in alcoholic

Korsakoff's Psychosis

17

What occurs in clients frequently who are recovering from Wernicke's encephalopathy?

Korsakoff's psychosis

18

A complication of alcohol abuse: when alcohol negatively affects the heart by LIPID ACCUMULATION in the myocardial cells, resulting in enlargement and a weekend condition (generally related to CHF or arrhythmia)

Alcoholic cardiomyopathy

19

What are symptoms of alcoholic cardiomyopathy? What would labs show? What should we observe? Is this treatable??

Symptoms: Decreased exercise tolerance, tachycardia, dyspnea, edema, palpitations, and nonproductive cough

Lab: Elevated enzymes, CPK, AST, alanine, ALT, and LDH

Observe ECH; CHF may be seen on x-ray

Treatable? CAN ONLY BE TREATED WITH HEART TRANSPLANT---and a heart will never go to an alcoholic unless they have been alcohol free for years (and even then, they aren't top of the list)

20

A complication of alcohol abuse: inflammation and pain in the esophagus occurring because of the toxic effects of alcohol on the esophageal musosa

Esophagitis

21

Esophagitis occurs because toxic effect of alcohol on the esophageal musosa. What is another reason this occurs? (2)

-Frequent vomiting associated with alcohol abuse
-Drinking HEAVY amounts of alcohol

22

A complication of alcohol abuse: Effects of alcohol on the stomach--> inflammation of the stomach lining characterized by epigastric distress, nausea, vomiting, and distintion

Gastritis

23

What happens in gastritis?

Alcohol breaks down the stomachs protective mucosal barrier, allowing HCl to erode the stomach wall

24

Complications of alcohol abuse: Is pancreatitis acute or chronic?

Can be either

25

Acute pancreatitis occurs ____ after binge of excessive ETOH consumption

1-2 days

26

What is steatorrhea? Does this happen in acute or chronic pancreatitis?

Fat globules in the stool--can occur in either

27

What does chronic pancreatitis lead to?

Insufficiency, resulting in steatorrhea, malnutrition, weight loss, and diabetes

28

Can you have pancreatitis without the cause being alcohol?

Yes-pancreatitis can happen in non-alcohol users

29

Complications of alcohol abuse: Inflammation of the liver cause by long-term heavy alcohol use

Alcoholic hepatitis

30

What are the clinical manifestations of alcoholic hepatitis?

Enlarged and tender liver, NV, lethargy, anorexia, elevated WBC, fever, JAUNDICE!!!

31

Alcoholic hepatitis: what may be evident in more severe cases?

Ascites or weight loss

32

What do severe cases of alcoholic hepatitis lead to?

Cirrhosis or hepatic encephalopathy

33

Complications of alcohol abuse: This complication is caused by overworking the liver trying to assimilate large amounts of alcohol

Cirrhosis of the liver

34

What happens to liver cells in cirrhosis of the liver?

Formulation of nodules, or lumps of regenerating liver cells; liver cells replaced with CT (fibrosis)

35

Complication of alcohol abuse: what is leukopenia?

Abnormal WBC count

*Impaired function, production, and mvnt. of WBC

36

When we hear leukopenia, what should we think?

Large risk of infection! bc it places the individual at a high risk of contracting diseases

37

Complication of alcohol abuse: What is thrombocytopenia?

Platelet production and survival is impaired as a result of the toxic effects of alcohol

38

When we hear a patient has thrombocytopenia, what should we think?

The client is at a higher risk for hemmorrhage

39

Abstinence from ETOH reverses thrombocytopenia slowly or rapidly?

Rapidly

40

Complication of alcohol abuse: what complication is this--alcohol interfere with the normal production and maintenance of F and M hormones?

Sexual dysfunction

41

Can sexual dysfunction cause a woman to become infertile?

Possibly because for women it can change the menstrual cycle and cause a decreased ability to become pregnant

42

Sexual dysfunction: For men, decreased hormone levels leads to decreased ___, ____, and impaired ______.

Long term effects?

Decreased hormone levels cause decreased LIBIDO, SEXUAL PERFORMANCE, and IMPAIRED FERTILITY

Long term: gynecomastia, sterility

43

Complication of alcohol: Exposure to alcohol while in the womb

FAS

44

What does FAS lead to?

Malfunctioning and deficits--physical malformations, emotional/behavioral regulation difficulties, learning disabilities

45

FAS babies look like?

Smaller babies
Ears a little lower
Cognitive abilities affected

46

Symptoms of alcohol intoxication?

Disinhibition of sexual or aggressive impulses
-Mood lability
-Impaire judgement
-Impaired social or occupational functioning
-Slurred speech
-Incoordination
-Unsteady gait
-Nystagmus
-Flushed face

47

What is considered intoxicated?
What is considered LEGALLY intoxicated?

Intoxiated: 100-200 g/dL
Legally intoxicated: 80 g/dL

48

When does alcohol withdrawal occur?

Within 4-12 hours of cessation/reduction in heavy or prolonged use

49

ATI: Alcohol withdrawal delirium may occur ____ days after cessation and may last ____

2-3 days after cessation and may last 2-3 days

50

Symptoms of alcohol withdrawal? (the Ps)

-Parkinsomnism (tremor)
-Puking (N/V)
-Pulse increase (tachycardia)
-Perspiration (sweating)
-Panic (anxiety)
-Pressure increase (elevated BP)
-Pyrexia (hot)
-Pooped (malaise)