Flashcards in T2-Substance-Related Addictive Disorders Pt. 1 Deck (50):
A physical or psychological dependence on a substance
*What is the most common ego defense mechanism?
The state in which a person's mental and physical abilities are impaired by alcohol or another substance
What is the blood alcohol level if a person is intoxicated?
The discomfort and distress that follow discontinuing the use of an addictive drug
When does withdrawal occur?
Within 4-12 hours of cessation in heavy or prolonged alcohol use
*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
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?"
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
Alcoholic myopathy is a complication of chronic alcohol abuse. Is alcoholic myopathy acute or chronic?
Can be either
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
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
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
*What is the most serious form of thiamine deficiency in alcoholics?
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
A complication of alcohol abuse: a syndrome of confusion, loss of recent memory, confabulation in alcoholic
What occurs in clients frequently who are recovering from Wernicke's encephalopathy?
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)
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)
A complication of alcohol abuse: inflammation and pain in the esophagus occurring because of the toxic effects of alcohol on the esophageal musosa
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
A complication of alcohol abuse: Effects of alcohol on the stomach--> inflammation of the stomach lining characterized by epigastric distress, nausea, vomiting, and distintion
What happens in gastritis?
Alcohol breaks down the stomachs protective mucosal barrier, allowing HCl to erode the stomach wall
Complications of alcohol abuse: Is pancreatitis acute or chronic?
Can be either
Acute pancreatitis occurs ____ after binge of excessive ETOH consumption
What is steatorrhea? Does this happen in acute or chronic pancreatitis?
Fat globules in the stool--can occur in either
What does chronic pancreatitis lead to?
Insufficiency, resulting in steatorrhea, malnutrition, weight loss, and diabetes
Can you have pancreatitis without the cause being alcohol?
Yes-pancreatitis can happen in non-alcohol users
Complications of alcohol abuse: Inflammation of the liver cause by long-term heavy alcohol use
What are the clinical manifestations of alcoholic hepatitis?
Enlarged and tender liver, NV, lethargy, anorexia, elevated WBC, fever, JAUNDICE!!!
Alcoholic hepatitis: what may be evident in more severe cases?
Ascites or weight loss
What do severe cases of alcoholic hepatitis lead to?
Cirrhosis or hepatic encephalopathy
Complications of alcohol abuse: This complication is caused by overworking the liver trying to assimilate large amounts of alcohol
Cirrhosis of the liver
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)
Complication of alcohol abuse: what is leukopenia?
Abnormal WBC count
*Impaired function, production, and mvnt. of WBC
When we hear leukopenia, what should we think?
Large risk of infection! bc it places the individual at a high risk of contracting diseases
Complication of alcohol abuse: What is thrombocytopenia?
Platelet production and survival is impaired as a result of the toxic effects of alcohol
When we hear a patient has thrombocytopenia, what should we think?
The client is at a higher risk for hemmorrhage
Abstinence from ETOH reverses thrombocytopenia slowly or rapidly?
Complication of alcohol abuse: what complication is this--alcohol interfere with the normal production and maintenance of F and M hormones?
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
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
Complication of alcohol: Exposure to alcohol while in the womb
What does FAS lead to?
Malfunctioning and deficits--physical malformations, emotional/behavioral regulation difficulties, learning disabilities
FAS babies look like?
Ears a little lower
Cognitive abilities affected
Symptoms of alcohol intoxication?
Disinhibition of sexual or aggressive impulses
-Impaired social or occupational functioning
What is considered intoxicated?
What is considered LEGALLY intoxicated?
Intoxiated: 100-200 g/dL
Legally intoxicated: 80 g/dL
When does alcohol withdrawal occur?
Within 4-12 hours of cessation/reduction in heavy or prolonged use
ATI: Alcohol withdrawal delirium may occur ____ days after cessation and may last ____
2-3 days after cessation and may last 2-3 days