What are some health promotion teachings for substance abuse?
Teach the effects on the body
Focus on fitness
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.
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
What is Polysubstance abuse?
The use of lots of drugs
Using one drug to counteract the other
What is dual diagnosis?
Substance abuse and mental illness combined
Usually substance abuse is a coping mechanism for mental illness
What are some biological theories that enhance compulsive substance abuse?
Controls basic functions such as heart rate, breathing and sleeping
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
Includes area that process information from our senses as well as areas that power our ability to think, plan, solve problems and make decisions
What is the pathophysiology of Alcoholism?
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.
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.
They have worn out their liver. In stage alcoholic disease. Destruction of the cells which causes the scar tissue.
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.
What specific body systems should we be assessing?
Mental Health Status
What is the progression of Alcoholism?
What is Pre-Alcoholic?
Using just for pleasure
Not go beyond everyday relief
Use for stress/tension
Can stay here forever
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
MAY seem some brief, infrequent black outs beginning
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
What is the late stage of alcoholism (Chronic phase)?
Emotional and Physical desentigration occurs
Intoxicated more than sober
Stage of helplessness, hopelessness
Chronic loss of control
Ascites: Typically seen with cirrhosis, interstitial fluid develops and they blow up like balloons
What are some other substances that are abused? P.249 WG
What are some possible effects of Narcotics/Opiods?
What is some pharmacology for treatment of ETOH?
AWS - Alcohol withdrawal Syndrome
Anti-Seizure medications (Tegretol, Depacote)
Thiamine (Prevent Werneke-Korsakoff)
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
What is pharmacology for Benzoiazepines and Sedatives? P.380 19-11
What is a specific body system assessment for narcotic overdose?
What is a specific body system assessment for narcotic withdrawal?
What is a priority assessment for a client in alcohol withdrawal?
If their blood pressure is HIGH HIGH HIGH, can kill them
Seizures can cause death also
What physical findings would you expect to see in a client under the influence of stimulants?
Increased Heart Rate
Visibly red nostrils
What are some interventions for substance abuse?
What are some rehabilitation's and considerations?
Commonly used, Tell them their liabilities, Call them on their BS, Encouraged
Must set firm limits
Expected to happen, If something happens and you use again all hope isn't lost
What are some common defense mechanisms for Alcoholics?
What are some assessments for alcohol withdrawals 8-9 hours after last drink (middle stage withdrawal)?
What are alcohol withdrawal symptoms that occur within 72 hours of last drink and can be life threatening?
Need to have Librium & Thiamin(Vit B) ready
What are some alternative therapies for Substance Abuse?
Depression from withdrawal, reverse some effects of hepatitis and cirrhosis
All withdrawal symptoms
Dec Alcohol Craving
Omega 3, Accupuncture, Magnesium, Vit CDEK, meditation, music, guided imagery
What organizations are available to help get through substance abuse?
Narcotic Anonymous (NA)
EAP - Employee Assistance Program
They help continue to work through 12 steps, may have to return to previous steps
What is it when there is a relationship with a non-substance abusing partner who stays with an abusing partner?
What are some diagnostic tests for alcoholic?
Liver Function Test
What are some possible effects of Narcotics (opium, morphine, codeine, heroin, meperidine, methadone)?
What are some possible withdrawal symptoms of Narcotics (opium, morphine, codeine, heroin, meperidine, methadone)?
Lose of apetite
Chills & Sweating
What are some possible effects of depressants (Chloral Hydrate, Barbiturates, Glutethimide, Tranquilizers)?
Drunken Behavior w/o odor of alcohol
What are some withdrawal effects of depressants (Chloral Hydrate, Barbiturates, Glutethimide, Tranquilizers)?
What are some overdose S&S of depressants (Chloral Hydrate, Barbiturates, Glutethimide, Tranquilizers)?
Cold & Clammy Skin
Weak and rapid pulse
What are some overdose S&S of Narcotics (opium, morphine, codeine, heroin, meperidine, methadone)?
Slow & shallow breathing
What are some possible effects of Stimulants (Cocaine, crack, amphetamines, phenmetrazine, methylphenidate)?
Increased Pulse rate & BP
Loss of Apetite
What are some overdose S&S of Stimulants (Cocaine, crack, amphetamines, phenmetrazine, methylphenidate)?
Increase in body temperature
What are some withdrawal symptoms of Stimulants (Cocaine, crack, amphetamines, phenmetrazine, methylphenidate)?
Long periods of sleep
What are some possible effects of hallucinogens (LSD, Mescaline, Psilocybin-psilocyn, MDA, PCP)?
illusions and hallucinations
Poor Perception of time & distance
What are some withdrawal s&s of hallucinogens (LSD, Mescaline, Psilocybin-psilocyn, MDA, PCP)?
No withdrawal symptoms reported
What are some possible effects of Cannabis (Marijuana, hashish)?
What are some overdose s&s of Cannabis (Marijuana, hashish)?
What are some withdrawal symptoms of Cannabis (Marijuana, hashish)?
What are some other addictive behaviors, besides subtances, that have the same brain changes?
What are some nursing diagnosis for substance abuse?
Ineffect individual coping
impaire Role Performance
What are some rehabilitation nursing interventions?
When pertaining to substance abuse, what is the RN responsible for?
What is HALT when pertaining to alternative therapies?
Don't get too.....