Test #5 - Substance Abuse Flashcards Preview

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Flashcards in Test #5 - Substance Abuse Deck (49):
1

What are some health promotion teachings for substance abuse?

Teach the effects on the body

Focus on fitness

 

2

What is substance dependence?

 

They have built up a tolerance

They have withdrawal when they do not have

It is a habitual psychological and physiological dependence on the substance or practive beyond one's voluntary control.

3

What is substance abuse?

 

It is the habitual use of a substance that falls outside of medical necessity or social acceptance for the single purpose of altering one's mood, emotion or state of conciousness and resulting in adverse effects to the abuser or to others

They have a psychological attachment

4

What is Polysubstance abuse?

 

The use of lots of drugs

Using one drug to counteract the other

5

What is dual diagnosis?

 

Substance abuse and mental illness combined

Usually substance abuse is a coping mechanism for mental illness

6

What are some biological theories that enhance compulsive substance abuse?

 

Brainstem:
Controls basic functions such as heart rate, breathing and sleeping

Limbic System:
Contains the brains reward circuit that links brain structures controlling feelings of pleasure, thereby motivating us to repeat behaviors causing pleasure such as eating, viewing art, listening to music

Cerebral Cortex:
Includes area that process information from our senses as well as areas that power our ability to think, plan, solve problems and make decisions

7

What is the pathophysiology of Alcoholism?

Blackouts:
First sign that there might be a problem-Periods of time that they were concious but don't remember

Peripheral Neuritis (Long Term Effect):
Later stages in alcoholism.  That tingling, numbing sensation.  Their blood flow has been compromised.

Gastric Ulcers:
They don't consume much of anything except alcohol. They aren't meeting their nutritional needs so a lot of acid is produced.

Pancreatitis (Common w/severe alcohol dependence):
Inflammation of the pancreatis.  Your filtering system is messed up. The only way to treat is let belly rest and pain medicine.

Wernicke-Korsakoff (Wet Brain) (Long Term) :
Wernicke is physical-Korsakoff is psychological
Wernicke=All the nutrients that the alcoholic isn't getting results in them having a low thiamine (vitb1). If they don't get they can have seizures/paralysis and die.
Treatment=Thiamine replacement (IV/IM)Korsakoff=Confusion, Loss of Memory, Confabulation - Characterized by: Ataxia, uncoordinated movements, confustion, confabulation. Functioning is intact but difficulty with long term memory or learning new things.

Cirrhosis:
They have worn out their liver. In stage alcoholic disease. Destruction of the cells which causes the scar tissue.

Esophageal Varices:
Portal Hypertension, blood vessel to the liver, gets backed up, and causes esophogus to have little pockets and they can blow up (Projectile RED blood like an explosion) And can cause death.

8

What specific body systems should we be assessing?

 

Cardiac

Mental Health Status

Nuerological

Nutritional Assessment

9

What is the progression of Alcoholism?

 

Pre-Alcoholic

Early Stage

Middle Stage

Late Stage

10

What is Pre-Alcoholic?

Using just for pleasure

Not go beyond everyday relief

Use for stress/tension

Can stay here forever

11

What is early stage of alcoholism?

Start to see some requirements-Not just casual

Pre-occupation-Can't wait to go get a drink, it's 5 o'clock somewhere syndrome

Sneakyness

Denial

Defensiveness

MAY seem some brief, infrequent black outs beginning

12

What is the middle stage of alcoholism (Crucial)?

This is the no turning back phase

Lost control over use of alcohol

Physiological dependence is evident

Withdrawals occur within 4-12 hourss
Tremors, irritation, Inc BP, irritability

Frequent Black outs

Multiple losses (Job, money, family, spouse, child) due to substance dependence

 

13

What is the late stage of alcoholism (Chronic phase)?

Emotional and Physical desentigration occurs

Intoxicated more than sober

Stage of helplessness, hopelessness

Suicide Common

Cirrhosis

Esophageal Varices

Wernicke-Korsakoff

Bleeding Ulcers

Chronic loss of control

Ascites: Typically seen with cirrhosis, interstitial fluid develops and they blow up like balloons

14

What are some other substances that are abused? P.249 WG

Hallucinogens

Cannabis

Amphetamines

Sedatives/Hypnotics/Antianxiety agents

Opiods

Caffeine

Nicotine

 

15

What are some possible effects of Narcotics/Opiods?

Euphoria

Drowsiness

Respiratory Depression

16

What is some pharmacology for treatment of ETOH?

Acute (Withdrawals):
AWS - Alcohol withdrawal Syndrome
Benzodiazepines
Anti-Seizure medications (Tegretol, Depacote)
Thiamine (Prevent Werneke-Korsakoff)
Beta-Blockers

Long Term (Maintenance):
Antabuse - Makes violently ill if they use alcohol in any form, not just drinking, hand sanitizer, aftershave, mouthwash. Can die from dehydration
Camprel = Reduces alcohol cravings

17

What is pharmacology for Benzoiazepines and Sedatives? P.380 19-11

Narcan

Clonadine

Subutex

18

What is a specific body system assessment for narcotic overdose?

Respiratory

19

What is a specific body system assessment for narcotic withdrawal?

GI

Neurological

 

20

What is a priority assessment for a client in alcohol withdrawal?

Circulatory:
If their blood pressure is HIGH HIGH HIGH, can kill them

Next Neurological:
Seizures can cause death also

21

What physical findings would you expect to see in a client under the influence of stimulants?

Chest Pain

Increased Heart Rate

Cocaine:
Nasal symptoms
Visibly red nostrils

22

What are some interventions for substance abuse?

PHYSICAL FIRST!!!!

 

23

What are some rehabilitation's and considerations?

Confrontation:
Commonly used, Tell them their liabilities, Call them on their BS, Encouraged

Limit Setting:
Must set firm limits

Co-Dependency:

Relapse:
Expected to happen, If something happens and you use again all hope isn't lost

24

What are some common defense mechanisms for Alcoholics?

Denial

Projection

Rationalism

25

What are some assessments for alcohol withdrawals 8-9 hours after last drink (middle stage withdrawal)?

Irritable

Sleeplesness

Fine Tremors

Increased BP

GI Disturbances

 

26

What are alcohol withdrawal symptoms that occur within 72 hours of last drink and can be life threatening?

Delirim

Tremors

Seizures

Hallucinations

Agitation

Need to have Librium & Thiamin(Vit B) ready

27

What are some alternative therapies for Substance Abuse?

SAMe
Depression from withdrawal, reverse some effects of hepatitis and cirrhosis

CHAMOMILE
All withdrawal symptoms

PRIMROSE OIL
Alcohol Withdrawal

GINSENG
Cocaine withdrawal

VALERIAN
Bezodiazepine Withdrawal

KUDZU
Dec Alcohol Craving

Omega 3, Accupuncture, Magnesium, Vit CDEK, meditation, music, guided imagery

28

What organizations are available to help get through substance abuse?

AA

Alanon

Alateen

Narcotic Anonymous (NA)

Halfway Houses

EAP - Employee Assistance Program

They help continue to work through 12 steps, may have to return to previous steps

29

What is it when there is a relationship with a non-substance abusing partner who stays with an abusing partner?

Co-Dependency

30

What are some diagnostic tests for alcoholic?

Liver Function Test

Ultrasound

31

What are some possible effects of Narcotics (opium, morphine, codeine, heroin, meperidine, methadone)?

Euphoria

Drowsiness

Respiratory Depression

Constricted Pupils

Nausea

Slowed Reaction

32

What are some possible withdrawal symptoms of Narcotics (opium, morphine, codeine, heroin, meperidine, methadone)?

Watery Eyes

Runny Nose

Yawning

Lose of apetite

irritability 

Tremors

Panic

Chills & Sweating

Cramps

Nausea

33

What are some possible effects of depressants (Chloral Hydrate, Barbiturates, Glutethimide, Tranquilizers)?

Slurred Speech

Disorientation

Drunken Behavior w/o odor of alcohol

34

What are some withdrawal effects of depressants (Chloral Hydrate, Barbiturates, Glutethimide, Tranquilizers)?

Anxiety

Insomnia

Tremors

Delirium

Convulsions

Possible Death

35

What are some overdose S&S of depressants (Chloral Hydrate, Barbiturates, Glutethimide, Tranquilizers)?

Shallow Respirations

Cold & Clammy Skin

Dilated Pupils

Weak and rapid pulse

Coma

Possible Death

36

What are some overdose S&S of Narcotics (opium, morphine, codeine, heroin, meperidine, methadone)?

Slow & shallow breathing

Clammy Skin

Convulsions

Coma

Possible Death

37

What are some possible effects of Stimulants (Cocaine, crack, amphetamines, phenmetrazine, methylphenidate)?

Increased Alertness

Excitation

Euphoria

Dilated Pupils

Increased Pulse rate & BP

Insomnia

Loss of Apetite

38

What are some overdose S&S of Stimulants (Cocaine, crack, amphetamines, phenmetrazine, methylphenidate)?

Agitation

Increase in body temperature

Hallucinations

Convulsions

Possible Death

39

What are some withdrawal symptoms of Stimulants (Cocaine, crack, amphetamines, phenmetrazine, methylphenidate)?

Apathy

Long periods of sleep

Irritability 

Depression

Disorientation

40

What are some possible effects of hallucinogens (LSD, Mescaline, Psilocybin-psilocyn, MDA, PCP)?

illusions and hallucinations
(Except MDA)

Poor Perception of time & distance

Flashback

41

What are some withdrawal s&s of hallucinogens (LSD, Mescaline, Psilocybin-psilocyn, MDA, PCP)?

No withdrawal symptoms reported

42

What are some possible effects of Cannabis (Marijuana, hashish)?

Euphoria

Relaxed Inhibitions

increased apetite

Disoriented Behavior

43

What are some overdose s&s of Cannabis (Marijuana, hashish)?

Fatigue

Paranoia

Possible Psychosis

44

What are some withdrawal symptoms of Cannabis (Marijuana, hashish)?

Insomnia

Hyperactivity

Decreased Apetite

Irritability

45

What are some other addictive behaviors, besides subtances, that have the same brain changes?

Internet

Sex

Food

Gambling

46

What are some nursing diagnosis for substance abuse?

Ineffect individual coping

Social Isolation

impaire Role Performance

Ineffective Denial

47

What are some rehabilitation nursing interventions?

Confrontation

Limit Setting

Co-Dependency

Relapse

48

When pertaining to substance abuse, what is the RN responsible for?

Client Advocacy

Medication Administration

49

What is HALT when pertaining to alternative therapies?

Don't get too.....

Hungry

Angry

Lonely

Tired