Test 1 (w 1-4) Flashcards
(115 cards)
1
Q
What is a substance ?
A
Psychoactive items that increase dopamine availability in the brain.
2
Q
What is the difference between a relief craving and a reward craving?
A
Shortly a relief craving occurs shortly after non-use. A reward-craving is cue-induced by people, settings, and situations.
3
Q
What are three approaches to managing substance use?
A
Harm reduction, trauma informed practice, and supportive dialogue.
4
Q
What are the 6 stages of change?
A
- pre contemplation 2. contemplation 3. preparation 4. action 5. maintenance 6. relapse
5
Q
What are side effects of nicotine?
A
Increased heart rate, blood pressure, and cardiac output. It also causes vasoconstriction to cutaneous tissues. It increases alertness and arousal. It can leave users feeling irritated tired and anxious.
6
Q
What are complications of smoking nicotine?
A
The carbon monoxide, tar, arsenic, and lead in tobacco products can cause COPD and various cancers.
7
Q
What interventions can be used for smoking cessation?
A
Medications like Nicorette, bupropion SR, and Vareniciline, behavioral approaches and cessation attempts.
8
Q
How can we identify alcohol intoxication?
A
This is evidenced by an increased BAC, behavioral or physical dysregulation, and impaired judgement.
9
Q
What are symptoms of alcohol withdrawal?
A
Tremors, anxiety, sweating, nausea and vomiting, agitation, insomnia, and hallucinations.
10
Q
What is the timeline for alcohol related symptoms?
A
6 to 12 hours we see tremors, insomnia, anxiety, sweating, and tachycardia
12 to 14 hours we see visual auditory or tactile hallucinations
24 to 48 hours we see seizures
48 to 72 hours we see delirium, disorientation, agitation, and sweating.
11
Q
How do we treat an alcohol withdrawal?
A
We use benzodiazepines like diazepam or lorazepam. Long term use of alcohol can cause Wernicke’s encephalopathy, which is hemorrhaging of the brain. This is caused by a thymine deficiency. If it is left untreated it can cause Korsakoff syndrome which is irreversible amnesia.
12
Q
What are long term symptoms of alcohol use?
A
Dementia, weakness, anemia, osteoporosis, liver cirrhosis, gastric ulcers, and palmar erythema.
13
Q
What’s the difference between THC and CBD?
A
THC can cause euphoria, relaxation, anxiety, and memory impairment. CBD mitigates some of these effects as it has antipsychotic and anti inflammatory properties.
14
Q
What are the uses and side effects of cannabis?
A
Appetite stimulation, elation, and pain relief. Side effects include panic, fear, trouble concentrating, and poor coordination.
15
Q
What withdrawal symptoms do we see with cannabis withdrawal?
A
Irritability, anxiety, decreased appetite, disturbed sleep, chills, headache, fever, and abdominal pain
16
Q
What support of care medications can we administer for cannabis withdrawal?
A
We can administer anti-emetics, analgesia, and hydration.
17
Q
What are opioids?
A
Opioids are analgesics derived from poppy. Include legal and illegal substances like morphine, methadone, and heroin.
18
Q
What are initial effects of opioid use?
A
Euphoria, analgesia, drowsiness, slurred speech, decrease peristalsis, and decrease respirations.
19
Q
What are signs of an opioid overdose?
A
Pinpoint pupils, clammy skin, decrease respirations, and decreased level of consciousness.
20
Q
What medication will we administer for an overdose of opioids?
A
Naloxone. Multiple doses may be required.
21
Q
What are opioid withdrawal symptoms?
A
Drug cravings, abdominal cramps, diarrhea, tremors, chills, body aches, sleep disturbances, anxiety, and nausea and vomiting.
22
Q
What is a general timeline for an opioid overdose?
A
Withdrawal can begin four to six hours after the last use and it peaks two to three days after last use. Usually resolves after five to seven days.
23
Q
What are stimulants?
A
These substances may be illicit like cocaine, crack, amphetamines or prescribed like methylpheniodate. By increasing dopamine in the brain.
24
Q
What are symptoms of stimulant use?
A
Increased heart rate and blood pressure, psychosis, agitation, and skin picking.
25
What does the stimulant withdrawal look like?
Withdrawal does not always cause physical symptoms. Can be intense for the first hours days after cessation. Symptoms may include depression, fatigue, prolonged sleep, vivid dreams, irritability, increased appetite, and disorientation.
26
What is the antidote for a stimulant overdose?
There is no antidote. Of care consists of creating a calm environment, encouraging sleep, clustering care to reduce interruptions, and providing sedatives to support sleep.
27
What effect do sedatives have on the body?
Sedatives like barbiturates and benzos can cause euphoria, impaired judgment, slurred speech, and loss of coordination.
28
What is the antidote for a benzo overdose?
Flumenzenil
29
What are symptoms of sedative withdrawal?
Tremors, anxiety, weakness, nausea, muscle cramps, increased alertness. An overdose may lead to delirium, seizures, and cardiac respiratory arrest.
30
What are the four classes of inhalants?
Volatile solvents, aerosols, anesthetic, and nitrates.
31
What symptoms do we see when inhalants have been used?
Most inherence are depressants and short term only lasting 60 to 90 minutes. They can cause neurological damage, heart failure, cardiac arrhythmia, and seizures.
32
Why are we less likely to identify drug use in older adults?
This is not usually fit with the idea that we have of older adults.
Drugs used in conjunction with over the counter medications, substances, alcohol and alcohol can have devastating interactions.
We may also perceive symptoms of drug use as symptoms of medical issues of aging.
33
What's the difference between acute and chronic pain?
Acute pain has a sudden onset and has a normal time for healing. The severity can be mild to severe and is caused by precipitating illnesses. The pain decreases over time and is manifested as an increased heart rate respiration rate and blood pressure, diaphoresis, pallor, anxiety, agitation, and confusion. The goal for acute pain is to control with eventual elimination.
Chronic pain has a gradual or a sudden onset. Start as an acute injury but it continues past the normal healing time. It may be mild to severe and its causes are idiopathic. The pain persists and it may be ongoing or persistent. Manifestations include changes in effect, decreased its activity, fatigue, and withdrawal, the goal for chronic pain is to minimize any pain and enhance function and quality of life.
34
What are barriers to understanding and treating pain?
The belief that pain is in an inevitable part of aging
A greater fear of using opioids
Use of words like aching soreness or discomfort instead of pain
35
What are some treatment cautions with pain management?
Older adults metabolize medications slower and are at greater risk for adverse effects
There is risk of GI bleeding with NSAIDs use
Multiple medications may cause interactions
Cognitive impairment and ataxia may be exacerbated
36
What information needs to be included in a PCA order?
Drug concentration loading dose, continuous infusion, PCA bolus dose, lockout interval in minutes, and 4 hour maximum dose
37
What do we assess for patients using PCA pumps?
Assess effects associated with opioid use like respiratory and CNS depression, the number of patient requests, the number of delivered requests, the number of milligrams delivered since last check, the total amount of narcotic delivered, pain score, sedation score, nausea score, and pruritis score
38
What information should be included in patient health teaching for PCA pumps?
How to use the pump, when to press the button, the lockout interval, and side effects.
39
What medications can be used during epidural?
Morphine, hydromorphone, fentanyl, and local anesthetics such as Bupivacaine
40
Which patients are candidates for an epidural?
Individuals undergoing thoracic, vascular, abdominal, urological, or orthopedic surgery as well as patients experiencing childbirth.
41
What are effects of epidural opioids?
Pruritis hypotension, respiratory depression, sedation, urinary retention, nausea and vomiting, and headache
41
What patients are not candidates for an epidural?
Individuals taking anticoagulants, individuals with bleeding disorders, spinal surgery or spinal deformity, and people allergic to local anesthetics
42
What is a dermatone?
This is an area of skin that is supplied by a single spinal nerve. These nerves really pain sensation to the brain. To landmark the sensory function of specific spinal nerves.
43
What are safety considerations for epidural?
Most adverse effects are related to infusion programming errors
Ensure there is dedicated non-ported IV tubing used
Clearly label the epidural
Ensure full lower limb motor control prior to ambulation
44
What are nerve blocks?
They are used to reduce pain by temporarily interrupting transmission of no susceptible input. This involves a one time or continuous infusion of local anesthetics into a particular area to produce pain relief.
45
What condition is an early sign of opioid overdose?
Myosis
46
During which stage of alcohol withdrawal would a client likely experience gastrointestinal symptoms?
Six to 12 hours after alcohol use
47
Which medication will the nurse anticipate administering when caring for a client with acute intoxication and a history of chronic alcoholism?
thiamine
48
Which stage of change of the trans theoretical model would the nurse consider a client who is unconcerned about their substance use?
pre-contemplation
49
What purpose would the nurse understand about the reason for naloxone administration?
To reverse the effects of opioid overdose
50
Which health problem is associated with the excessive use of a sedative hypnotic?
Risk of fractures
51
Which explanation would the nurse understand as why an alcohol dependent client who is currently not drinking may require an increased level of anesthesia during surgery?
Cross tolerance
52
Which symptom is related to nicotine withdrawal?
Increased irritability
53
which parameter would the nurse measure to detect adverse effects of therapy with diazepam?
Respirations
54
What assessment finding would alert the nurse to possible cocaine use?
Insomnia
55
Which pupillary abnormality would the nurse expect to find when assessing a client admitted to the hospital for opium toxicity?
Pinpoint pupils
56
Which explanation would the nurse understand causes hypoxemia in a client with a history of chronic tobacco smoking?
Carbon monoxide decreases the oxygen capacity of the blood
57
Which description can be given by a nurse educator conducting a class on pain that best describes nociception?
It is the process of communicating information about tissue damage to the central nervous system
58
Which medication will the nurse prepare to administer for the client experiencing respiratory depression following intravenous administration of morphine?
naloxone
59
Which information should the nurse educator include in a teaching session about the important role chemicals such as substance P play in pain pathways?
These chemicals stimulate the nociceptors
60
Which explanation will the nurse understand regarding how ibuprofen works to relieve acute back pain?
It interferes with the production of prostaglandins
61
Which statement is correct about using heat therapy to relieve arthritis pain?
Do not use menthol containing products with heat applications
62
Which medication would the nurse teach a client to avoid while taking ibuprofen?
Aspirin
63
Which clinical manifestation would the nurse instruct a client receiving non-steroidal anti-inflammatory drugs to report?
black or tarry stools
64
Which statement should the nurse include in information used to teach a client about pain management?
Pain needs to be reported if it is not relieved to tolerable levels
65
Which adverse effective morphine would the nurse try to prevent with oral intake and medication for a client with metastatic lung cancer?
Constipation
66
Which assessment finding may indicate a harmful effect of morphine 15 milligrams prescribed every three hours for a post operative bariatric client?
bradypnea
67
Which action will the nurse implement to prevent aspiration in a patient who is recovering from anesthesia and vomiting?
Place the patient in a lateral recovery position
68
The nurse plans care for the patient with gas pain and abdominal distension two days after a cholectomy knowing that these symptoms occur as a result of which condition?
Slowed gastric emptying
69
Which food is part of a postoperative soft diet?
pasta
70
Which action would the nurse implement first for a patient who had surgery and is now displaying manifestations of delirium?
Track the preoperative assessment for previous delirium or dementia
71
Which explanation would the nurse provide to a patient with heart failure and atrial fibrillation who asks for an anticoagulant has been prescribed?
to help prevent a thrombus that may lead to a stroke
72
Which action will the nurse working on the surgical unit take first when receiving a patient from the pacu?
Assess the patient's vital signs
73
Which explanation would the nurse provide to the patient who had surgery to donate a kidney and early ambulation is included in the plan of care when the patient refuses to get up and walk?
Early walking is the best way to prevent postoperative complications
74
To prevent the complication of atalectasis in a patient who has had abdominal surgery which intervention with the nurse perform?
encouraging the use of an incentive spirometer at least every hour
75
It's important instruction would the nurse include when teaching deep breathing and coughing techniques to a postoperative patient with an abdominal incision?
Splint the abdominal incision with a pillow
76
Which intervention is the priority for the nurse to implement when caring for a postoperative patient who had a Foley catheter removed at 1200 hours and at 2100 hour the patient has still not voided?
assess for bladder fullness by percussion palpation or a portable bladder scanner
77
Which action would be in the first phase of post anesthesia care?
Monitor patient after anesthesia
78
Which colour would see a nurse expect the drainage from a T tube to be?
Green
79
Which finding would be noted in a patient who is ready to be discharged from an ambulatory surgical centre?
No intravenous opioids for 30 minutes
80
Which parameter would the nurse include in the pain assessment of a postoperative patient receiving pain medication via epidural catheter?
motor function
81
Which patient would the nurse assess as being at highest risk for thrombophlebitis?
A hospitalized patient who's been on bed rest for three days
82
Which type of infection would the nurse evaluate for in a postoperative patient who develops fever abdominal pain and diarrhea despite being on long term antibiotics?
C diff
83
Bronchial obstruction by retained secretions has contributed to a postoperative patient's recent pulse oximetry reading of eighty-seven percent what health problem is the patient most likely experiencing?
Atalectasis
84
Which condition would the nurse suspect a patient most likely has when they present to the clinic with a chronic cough, sputum production, and dyspnea and reports a history of prolonged exposure to smoke?
COPD
85
Which common ideological factor would the nurse understand is associated with the nursing diagnosis of ineffective airway clearance for a patient with asthma?
Bronchospasm
86
Which disease is an autosomal recessive multi system disease characterized by altered function of the exocrine glands?
Cystic fibrosis
87
Which pathophysiological change in the alveolar sacs is most characteristic of emphysema?
the alveolar sacs are over distended
88
Which clinical manifestation is an early sign of chronic obstructive pulmonary disease?
A chronic intermittent cough
89
Which respiratory defence mechanism would the nurse recognize is decreased related to a history of smoking in a patient with COPD?
Hyperplasia of cells
90
Which rationale would the nurse understand for postural drainage therapy on a patient with cystic fibrosis?
drain secretions from specific segments of the lungs and bronchi into the trachea
91
Which oxygen delivery system would the nurse select to deliver the precise amount of oxygen to a patient with COPD?
venturi mask
92
What are the two most common alterations in respiratory function in postoperative care?
Pneumonia and atelectasis
93
What are potential alterations of the cardiovascular system following postoperative care?
Fluid and electrolyte imbalance, DVT, pulmonary embolism, and syncope
94
What is a neurological alteration following postoperative care?
Delirium
95
What are potential alterations in gastrointestinal function postoperative care?
postoperative nausea and vomiting, post-op Ileus and paralytic Ileus (persists>2-3days)
96
What are potential alterations in psychological function post operative care?
Anxiety, depression, alcohol withdrawal, confusion, and delirium
97
What is asthma?
It's a chronic inflammatory disorder of the Airways. Causes varying degrees of obstruction in the airways leading to wheezing, breathlessness, chest tightness, and cough
98
What are triggers for asthma?
Smoke, exercise, respiratory infections, environmental factors, Medications like beta adrenergic blockers and ace inhibitors, GERD, air pollution, and emotional stress
99
What medications do we use for asthma?
We use two groups of medications. Are relievers or rescue medications. They include bronchodilators and anticholinergics. The second group are controllers for maintenance therapy. They are corticosteroids
100
What is COPD?
COPD is a respiratory disorder. It is preventable and characterized by persistent airflow limitation that is progressive. It is associated with chronic inflammatory response caused by smoking. COPD includes emphysema which is the destruction of the alveoli as well as chronic bronchitis.
101
What are risk factors for COPD?
Cigarette smoking, aging, air pollution, infections, and heredity.
102
What are clinical manifestations of COPD?
Cough, sputum production, dyspnea, history of smoking or exposure to risk factors, hypoxemia, chronic fatigue, weight loss, and accessory muscle use
103
What are complications that can arise from copd?
Cor Pulmonale (lung dysfunction causing right sided heart failure), acute exacerbations of COPD, acute respiratory failure, peptic ulcer disease, and depression or anxiety
104
What are manifestations of cor pulmonale?
Dyspnea, distended neck veins, hepatomegaly, ascites, epigastric distress, peripheral edema, and weight gain
105
What treatment do we use for COPD?
Medications like bronchodilators, breathing exercises, and ensuring we have adequate intake.
106
Which explanation will the nurse understand about the reason for IV thiamine administration for a client experiencing alcohol withdrawal?
To prevent Wernicke's encephalopathy
107
Which conditions would research identify can be caused by cigarette smoking?
Cataracts, stroke, C O P D
108
What time of onset after the last use of alcohol would show generalized seizures as a withdrawal symptom?
24 to 48 hours
109
What symptoms would the nurse recognize that the client might experience when trying to quit chewing tobacco?
Headache, drowsiness, restlessness
110
What is a manifestation of cocaine withdrawal?
Prolonged sleep and disorientation
111
What is the sign of Warnock's encephalopathy?
Nystagmus
112
What is the symptom of cocaine overdose?
Agitation and cardiac dysrhythmia
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