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Nsg 3120 > Week 5 > Flashcards

Week 5 Flashcards

(43 cards)

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1
Q

What are the stages in the trajectory of addiction?

A
  • No Contact
  • No use
  • Experimental use
  • Integrated use
  • Social or Occasional use
  • Excessive use
  • Misuse
  • Addiction

Stages represent a continuum of substance use from abstinence to addiction.

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2
Q

What are the three main aspects of dependence related to addiction?

A
  • Tolerance
  • Dependence
  • Withdrawal

These aspects are crucial in understanding the physiological and psychological components of addiction.

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3
Q

What are flashbacks in the context of addiction?

A

Range from mild/pleasant to frightening, including visual distortions and intense emotions.

Flashbacks can be a significant issue for individuals recovering from substance use.

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4
Q

Define synergistic effects in substance use.

A

Combination effect of one or more drugs, resulting in greater total sum of effects.

This can lead to enhanced drug effects and increased risks.

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5
Q

Define antagonistic effects in substance use.

A

Combination effect of one or more drugs resulting in inhibiting effect of one of the drugs.

This can mitigate the effects of certain substances.

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6
Q

What is codependence?

A

Passive attention to own needs, excessive attention to others’ needs (i.e. control over behaviour, guilt, responsibility).

Codependence often affects relationships and recovery processes.

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7
Q

List some reasons why individuals may use substances.

A
  • Media influence
  • Positive reinforcement
  • Curiosity
  • Celebration
  • Emotional pressure
  • Social pressure
  • Previous use
  • Dependence

Understanding these motivations can help in prevention and treatment strategies.

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8
Q

What are the types of trauma related to addiction?

A
  • Psychological
  • Physiological
  • Social
  • Vicarious
  • Intergenerational
  • Collective

These traumas can significantly impact an individual’s susceptibility to addiction.

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9
Q

What are the 4 Cs of addiction?

A
  • Loss of Control
  • Compulsions
  • Cravings
  • Consequences

These components are essential for understanding the behavioral aspects of addiction.

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10
Q

What are concurrent disorders?

A

Substance abuse/addiction problem combined with a mental health diagnosis.

This often leads to more severe and chronic medical, social, and emotional problems.

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11
Q

What does the C.A.G.E. assessment evaluate?

A
  • Cutting down on drinking
  • Annoyance by others’ criticism
  • Guilt about drinking
  • Eye-opener drink in the morning

C.A.G.E. is a screening tool for identifying potential alcohol use disorders.

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12
Q

What does CIWA-Ar stand for?

A

Clinical Institute Withdrawal Assessment for Alcohol-revised.

This assessment tool measures withdrawal symptoms in patients.

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13
Q

What are some general assessment guidelines for substance use?

A
  • Current substances used
  • Recent use
  • Route of administration
  • Age at first use
  • Family history of substance use
  • Effect of use on mental illness
  • Negative consequences of use
  • Insight into difficulties caused by use
  • Evidence of physical dependence
  • Past treatment
  • Stage of readiness for change

These assessments help clinicians understand the extent and impact of substance use.

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14
Q

What are some nursing interventions for addiction?

A
  • Motivational Interviewing
    —> cognitive dissonance is a core technique
  • Counseling (individual and family)
  • Relapse prevention support
  • Psychobiological interventions
    —> pharmacology
  • Health teaching and health promotion

These interventions are aimed at supporting recovery and managing addiction.

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15
Q

When should hospitalization be considered for substance use issues?

A
  • Serious medical needs
  • Exacerbated medical disorder
  • Suicidal/homicidal ideation
  • Failed outpatient treatment
  • Addiction severity
  • Psychosocial problems
  • Continued use during pregnancy

These criteria help determine the need for more intensive treatment.

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16
Q

What are some effects of CNS depressants like alcohol?

A
  • Relaxed inhibitions
  • Heightened emotions
  • Mood swings
  • Cognitive impairments
  • Impaired judgment and memory

Excessive use can lead to severe complications, including alcohol poisoning.

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17
Q

What is Wernicke’s encephalopathy?

A

An acute and reversible condition caused by thiamine deficiency with symptoms including oculomotor dysfunctions, ataxia, and confusion.

It is often associated with chronic alcohol abuse.

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18
Q

What is Korsakoff’s syndrome?

Study These Flashcards
A

A chronic condition with a recovery rate of only about 20%, characterized by retrograde and anterograde amnesia and confabulation.

Treatment involves thiamine replacement over several months.

19
Q

What distinguishes barbiturates from benzodiazepines?

Study These Flashcards
A
  • Overdose Potential: Barbiturates (High), Benzodiazepines (Moderate)
  • Risk of Fatality: Barbiturates (High), Benzodiazepines (Low)
  • Antidote: Barbiturates (None), Benzodiazepines (Flumazenil)

Understanding these differences is crucial for treatment and emergency situations.

20
Q

What is the Recovery Model (C.H.I.M.E.)?

Study These Flashcards
A
  • Connectedness
  • Hope
  • Identity
  • Meaning in life
  • Empowerment

This model emphasizes holistic recovery beyond just symptom management.

21
Q

What are synergistic effects

Study These Flashcards
A

Combination effect of one or more drugs, resulting in greater total sum of effects

22
Q

What antagonistic effects

Study These Flashcards
A

Combinations ffect of one or more drugs resulting in inhibiting effect of one of the drugs

23
Q

What is codependence

Study These Flashcards
A

Passive attention to own needs, excessive attention to others needs (i.e control over behaviour guilt, responsibility)

24
Q

Why use substances

Study These Flashcards
A
  • media influence
  • positive reinforcement
  • curiosity
  • celebration
  • emotional pressure
  • social pressure
  • previous use
  • dependence
25
Types of trauma
Psychological, physiological, social, vicarious, intergenerational, collective
26
What are some variations in combinations of concurrent disorders
- ETOH + other substances, mood disorders, ASPD - drugs + ASPD and BPD - ETOH/poly substance + schizophrenia - drug dependence + GAD and mood disorders
27
8 most common dual diagnosis
1. Bipolar disorder 2. Post traumatic stress disorder 3. Attention deficit hyperactivity disorder (ADHD) 4. Anxiety 5. Obsessive- compulsive disorder (OCD) 6. Depression 7. Panic disorder 8. Schizophrenia
28
Assessment guidelines: acute substance impairment
1. Assess for severe or major withdrawal syndrome 2. Assess for drug poisoning that warrants immediate medical attention 3. Assess the patient for suicidal thoughts or other self harming behaviours 4. Evaluate patient for any physical complications related to frug use 5. Explore the patients interest in doing something about their drug problems 6. Assess the patient and family’s knowledge of community resources for addiction treatment
29
Transtheoretical model of change
Relapse Precontemplation Contemplation Preparation Action Maintence —> stable lifestyle Relapse
30
The relapse cycle
Attempted abstinence Re-emerging psychiatric symptoms Ineffective coping strategies Increased anxiety Substance use to avoid painful feelings Adverse consequences
31
What is a primary prevention model
Reducing demand, stopping use and addictive behaviours
32
What is secondary prevention models
- Limit further harm, early recognition, community support - harm reduction, relapse prevention, self help, 12 step
33
Tertiary prevention models
- limiting complications and dysfunction - detoxification, rehabilitation, residential treatment programs, intensive outpatient programs
34
Effects and complications of CNS depressant alcohol
- relaxed inhibitions, heightened emotions, mood swings, cognitive impairments, impaired judgement and memory - excess can result in alcohol poisioning, coma, respiratory failure, death - delirium Tremens (DT) - acute withdrawal —> tachycardia, sweating hypertension, irregular tremor, delusions, hallucinations, agitated behaviour, fever, insomnia, anorexia, fluctuating consciousness
35
Alcohol induced CNS disorders
Wernicke’s (alcoholic) encephalopathy - an acute and reversible condition - thiamine deficiency - not exclusive to alcohol abuse - occulomotor dysfunction, ataxia, confusion - tx 1-2 weeks of thiamine replacement Korsakoff’s syndrome - a chronic condition with a recovery rate of only about 20% - retrograde and anterograde amnesia - confabulation a key feature - highly suggestible, poor judgement and reasoning -tx 3-12 months of thiamine replacement
36
CNS depressants - Barbiturates
- phenobarbital - amtytal - Seconal AKA - downers - stumblers - sleepers - yellow jackets - red dolls - tootsies - rainbows
37
CNS depressants - Benzodiazepines
- ends in Pam or lam AKA - benzos - downers - goofballs - tranx - valley girl (Valium) - heavenly blues - stupefy
38
Withdrawal from benzodiazepines
- Acute phase (7-90days) - length depends on action of drug (short vs long acting) - anxiety rebound - anorexia, insomnia, agitation - autonomic rebound - hypertension, tachycardia, fever - sensory excitement - illusions, sensitive to light and sound - motor excitation - tremors, hyper-reflex is- muscle weakness, convulsions - cognitive excitation - nightmares, delirium, hallucinations
39
Acute post withdrawal syndrome (PAWS)
- can last up to 2 years, usually mild - increase in anxiety and insomnia
40
Symptoms of Benzodiazepine withdrawal
- nausea - insomnia - grand maul seizures - abnormal body sensations - aches/pains - delirium, detachment from reality - muscle spasms - anxiety and panic attacks - depression
41
Barbiturates (BA) vs benzodiazepines (BE)
Potential over dose - BA- HIGH - BE- moderate Risk of fatality - BA - High (even small overdoses) - BE - low (when taken alone) Antidote - BA- none -BE - flumazenil Duration - BA - Long - BE varies Modern uses - BA- rare BE- Common
42
Medical mimics of intoxication
- stroke/tia - hypoglycaemia - electrolyte imbalances (low sodium, high calcium) - sepsis or delirium - medicaiton side effects (antipsychotics, sedatives, anticonvulsants) - neurological disorders (Parkinson’s, MS) - mental health conditions (psychosis, depression)
43
Recovery oriented practices
- includes support for housing first, employment, education, family, heathly eating, and basic promotion to build a meaningful, hopeful and successful life - revcovery may be seen as moving towards these conditions, rather than being free from symptoms

Nsg 3120 (5 decks)

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