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a normal biological adaptation to long-term use of a drug.



a normal physiological response that most people experience after a week or more of continuous opioid use. If an opioid is discontinued abruptly or if an opioid antagonist such as naloxone (Narcan) is administered, the patient experiences withdrawal syndrome

physical dependence


a disease of the brain that causes the compulsive pursuit of a substance or behavior to obtain reward or relief from craving. Addiction is characterized by poor control over drug use, craving, reduced recognition of problem behaviors, and continued use despite harm.

Addiction or psychological dependence


described in patients who are receiving opioid doses that are too low or spaced too far apart to relieve their pain. 



Early stage alzheimer's

no apparent manifestation


What stage of alzheimer's is this?

(forgetfullnes of glasses or wallet, no memory problems)

Stage 2 alzheimer's


the followinf is what stage of alzheimer's

mild cognitive decline
(inability to plan, decreased attention, unable to remember names, difficulty in social or work situations)

Stage 3 alzheimer's


The following is what stage of alzheimer's

mild to moderate cognitive decline
(withdrawn, obvious memory loss, limited knowledge, difficulty performing task planning or organzing, depression and social withdral)

Stage 4 alzheimers


the following is what stage of alzheimer's

moderate cognitive decline
(inability to recall important details such as address, telephone, schools, assistance with adls become necessary, disorientation and confusion as to time and place)

stage 5 alzheimers


the following is what stage of alzheimer's

moderate to severe cogntive decline (late stage)
(loss of awareness to recent events, can recall name but not hx, significant personality changes, wandering behavior, x1 w/adls, normal sleep cycle is disrupted, increased episode of incontinence

stage 6 alzheimer's


The following is what stage of alzheimer's

severe cognitive decline
(inability to respond to enviorment, speak, control movement is lost, unrecongizible speech, incontinence, inability to eat w/o assistance and impaired swallowing, ataxia)

stage 7 alzheimer's


What can cause problems with older adults and medication doses? What system changes are there?

risk for toxic reactions, risk for adverse drug reaction due to multiple prescribed drugs, everything in older adults diminishes GI, inability to exert drugs.
System changes include- GI, body fat, plasma proteins, hepatic function, renal function.


negative symptoms of schizophrenia

include affective blunting or flattening, alogia, avolition, apathy, anhedonia, and social isolation.


The following are s/s of what:

Patients are usually hospitalized for exacerbation of positive symptoms, which include hallucinations, delusions, disorganized thinking, and disorganized behavior.
Establish a therapeutic rapport with the patient, Convey acceptance and unconditional positive regard for the patient. Assure the patient of his or her safety.
Offer to accompany patient to milieu activities. Acknowledge the patient’s efforts to interact and attend activities. 

positive symptoms of schizophrenia


the following are s/s of what?

Pale or flushed face, YELLING, SWEARING, agitated, threatening, demanding, clenched fist, threatening gestures, hostility, loss of ability to solve the problems or think clearly

s/s of excalating behavior


elevated mood, expansive and irritable;
requires hospitilzation,
last for 1 week.



The following are s/s of what?

agitation, reslteness, intolerance of criticism, increase talking and activity, flight of ideas, grandiosity, impulsive, manipulative behavior, decreased attention span, poor judgment, attention seeking behavior, decreased sleep, neglect of adls, delusions/hallucinations, denial of illness

s/s of mania


last 4 days accompanied w/3or more manifestions of mania. No Hospital req.

depressed (hypomania)


flat, blunted labile effect, tearfulness, lack of energy, anhedonia; loss of pleasure and interest activites hobbies sexual activity, reports pain, difficulty concentrating, decrease in personal hygiene, loss or increase of appetite, retardation or agitation.

S/S of depression or hypomania


Fear of gaining weight, disturbance in self-perceived weight or shape, intake restriction leading to low body weight.



s/s of anorexia

weight loss/ gain, refusal to eat, hx of dieting, methods of weight control, value attached to shape of body, lack of nurture, low bp, brittle skin and nails, irregular hr, Acidosis or Alkalosis, dehydration, muscle weakness, low energy, bone loss density, GI Issues, irregular periods


Client eats a great deal of calories and follows with purging behaviors of enema, laxatives, diuretics, self-induced vomiting. Binge eating followed by guilt.



s/s of bulimia

distress before eating episode, once per weeks for 3 months, weight gain.


inability to concentrate on a single thought.
Can progress to flight of ideas in which client speech moves rapidly. Incoherent thoughts.

associative looseness


made up words that have meaning only to client “I tranged and flittled”



repetition of words spoken to them



meaningless rhyming of words “ oh fox, box, lox”

clang association


words jumbled together with little meaning to the listener. “hip hooray, the flip is cast and wide sprinting in the forest”

word salad


words jumbled together with little meaning to the listener. “hip hooray, the flip is cast and wide sprinting in the forest”

word salad


multiple and unneeded details during a conversation; such as detail the weather and clothes they are wearing when asked what their plan for the day is.