Addiction: General Concept/Alcoholism Flashcards

1
Q

What is dependence?

A
  1. A physiological need for a substance that a client cannot control
  2. results in withdrawal symptoms if the substance is withheld
  3. Dependence on a substance also results in the user developing a physiological tolerance for the substance, requiring use of greater quantities to achieve the same effect
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2
Q

What is addiction?

A
  1. physiological process of dependence as well as psychological need to seek substance
  2. Causes addicts to seek out substances at any cost
  3. may neglect children, work, and other responsibilities
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3
Q

What biological factors can contribute to addiction?

A
  1. hypothesis that addiction has a biochemical basis

2. related to dopamine and dopamine receptor sites

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4
Q

What genetic factors can contribute to addiction?

A

Hereditary factors that affect alcohol use and dependence

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5
Q

What are the three types of theories for alcoholism and what do they believe about what it is caused by?

A
  1. Psychoanalytical theorists view substance abuse as a fixation at the oral stage of development
  2. Behavioral theorists see addiction as a learned maladaptive behavior
  3. Family system theory focuses on a dysfunctional pattern of family relationships through several generations
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6
Q

What emotional factors can lead to addiction?

A

Pleasure model: views addiction as an emotional fixation acquired through learning that is aimed at obtaining pleasure and avoiding discomfort

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7
Q

What sociocultural factors can lead to addiction?

A
  1. often influence individuals’ decisions as to when, what, and how they use substances
  2. personality, religion/spirituality, financial resources, peer pressure, and cultural acceptance
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8
Q

Why are adolescents and young adults at risk for addiction?

A
  1. developmental transitions such as puberty and increasing independence have been associated with alcohol use
  2. binge drinking
  3. Experiments with other addictions, smoking, drugs sexuality, and promiscuity
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9
Q

Why are middle-aged adults at risk for addiction?

A
  1. depression
  2. empty nest syndrome
  3. Divorce, unemployment, health setbacks, retirement, death of a parent or spouse
  4. alcohol, prescription drugs, illicit drugs
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10
Q

Why are older adults at risk for addiction?

A
  1. underestimated, underidentified, undertreated

2. symptoms may mimic other medical and behavioral disorders common among older adults

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11
Q

What are some alterations and manifestations of substance abusers?

A
  1. higher rates of mental health disorders than the general population
  2. more than 40% of those treated for substance abuse have at least one mood disorder
  3. Depression may be part of the addiction problem
  4. Numerous social problems
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12
Q

What are some alterations and manifestations of non-addicted members (enablers)?

A
  1. inadvertent supporters of addicts’ behaviors
  2. any action in individual takes that consciously or unconsciously facilitates substance abuse
  3. Family members making excuses to employers or teachers
  4. Family members discontinuing their own social relationships with friends or neighbors to “keep up appearances”
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13
Q

What are the effects of addiction on families when it’s a family problem?

A
  1. alters family problems

2. alters behaviors of individual family members

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14
Q

What are the effects of addiction on families when a parent is abusing substances?

A
  1. devastating to the family
  2. power struggles between abusing and non-abusing partners
  3. Contributing factor to emotional neglect, physical or sexual abuse
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15
Q

What ineffective communication patterns may happen in the family when addiction is involved?

A
  1. contributes to anxiety and anger
  2. substance abuse not discussed within or outside family system
  3. family dependence
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16
Q

How can addiction be prevented?

A
  1. substance abuse and Mental Health Services Administration
  2. Federal initiatives, law enforcement, local and mental health professionals
  3. community and local initiatives
  4. Nurses assess clients’ risk for substance abuse and provide education related to prevention
  5. Focus on healthy coping mechanisms and obtaining treatment for existing mental health disorders such as depression
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17
Q

Why is having good communication important with patients who have an addiction?

A
  1. client at the center of all communication
  2. respect, empathy and caring are essential components of those with addiction
  3. many clients with addictions have poor communication skills
  4. clients experienced at hiding addictions, avoiding discussion of the addiction (need assistance with verbal and nonverbal communication; assertiveness training)
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18
Q

What is an addiction crisis?

A

when the usual resources and coping skills are no longer effective

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19
Q

What crisis intervention is needed?

A
  1. addict’s poor life management skills result in crisis (event needs to be perceived subjectively as a threat)
  2. During crisis situations the addict most likely will be motivated to seek help (most receptive to professional intervention)
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20
Q

What are the three parts of conditioning used in Behavioral Therapy?

A
  1. reinforcement- provides a reward for desired behavior
  2. Punishment- consequences that lead to a decrease in undesirable behavior
  3. Extinction- Progressive weakening of an undesirable behavior through repeated non-reinforcement of the behavior (family ignores negative attention-seeking behaviors)
21
Q

What things does Milieu Therapy emphasize?

A
  1. clients as responsible individuals
  2. group and social interaction
  3. clients’ rights to choose and participate in a variety of treatments
  4. informality of relationship with healthcare professionals
22
Q

What is group therapy?

A
  1. group members help each other through process of change
  2. aided by professional group therapist
  3. held in a variety of settings
  4. Effective with children and adolescents
  5. The leader helps members relate to one another
23
Q

What are support groups?

A
  1. members share thoughts and feelings

2. help one anther examine issues

24
Q

What is the function of support groups?

A
  1. educate community members
  2. help family and friends support the individual
  3. act as crisis support and referral source
  4. advocate
  5. help clients form a healthier base of support
  6. Provide interpersonal contact
  7. Increase self-esteem and dignity
25
Q

What are twelve-step programs?

A
  1. support groups with a spiritual plan for recovery
  2. prescribed beliefs, values, and behaviors
  3. sequential plan for recovery
  4. only requirement: sincere desire to change
26
Q

What is family therapy?

A
  1. family system treated as a unit
  2. focus on family dynamics
  3. all family members are part of the process
27
Q

What are the goals of family therapy?

A
  1. teach better parenting and nurturing skills
  2. establish boundaries
  3. improve family communication
  4. teach the family to problem solve
28
Q

What are the risk factors for alcoholism?

A
  1. phenotypes
  2. biological factors
  3. ethnic differences in the way alcohol is metabolized
  4. religious backgrounds
  5. developmental considerations
  6. Children of Alcoholics (higher risk; primarily true with male relatives
29
Q

What are the clinical manifestations of alcohol abuse?

A
  1. cravings
  2. diminished ability to function
  3. severe liver damage
  4. malnutrition
  5. Wernicke encephalopathy: Thiamine depletion
  6. Severe cognitive impairment
  7. Korsakoff psychosis (memory deficits, confusion, behavioral changes)
  8. disrupts sleep
  9. accidents
  10. produces tolerance (with alcohol and other CNS depressants)
30
Q

What population is 5 times more often in older adults to get dementia?

A

Those with alcoholism rather than nondrinkers

31
Q

When do alcohol withdrawal symptoms typically being after the last drink?

A

6-8 hours

32
Q

How long does alcohol withdrawal delirium occur?

A

Days 2-3 of withdrawal

33
Q

What are the early symptoms of alcohol withdrawal?

A
  1. irritability
  2. anxiety
  3. insomnia
  4. tremors
  5. sweating
  6. Mild tachycardia
  7. Rare: seizures, visual, tactile, or auditory hallucinations
34
Q

What are the symptoms of Alcohol withdrawal delirium?

A
  1. confusion
  2. disorientation
  3. hallucinations
  4. Tachycardia and hypertension
  5. Extreme tremors
  6. Agitation, diaphoresis, and fevers
35
Q

What are the signs of alcohol intoxication?

A
  1. nausea
  2. vomiting
  3. lack of coordination
  4. slurred speech
  5. staggering
  6. Disorientation
  7. irritability
36
Q

What are the results of alcohol intoxication?

A
  1. accidents
  2. falls
  3. alcohol poisoning
37
Q

What diagnostic tests confirm alcohol intoxication?

A
  1. breathalyzer

2. Blood alcohol level

38
Q

What are the goals of treatment?

A
  1. minimize adverse outcomes of withdrawal

2. avoid adverse effects of withdrawal medications

39
Q

What are the two contrasting treatment approaches to alcoholism?

A
  1. fixed-schedule dosing

2. symptom-triggered approach

40
Q

What medications are typically used for alcoholism?

A
  1. disulfiram (Antabuse)- causes intense vomiting if alcohol is consumed
  2. Naltrexone- blocks pathway to the brain that triggers the feeling of pleasure with alcohol and other narcotics
41
Q

What screening tools are typically used for alcoholics?

A
  1. Michigan Alcohol Screening tool Brief Version- 10 questions, self-administered
  2. CAGE- questionnaire is self-report
  3. Nonthreatening questions
  4. Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA)- 10 item assessment tool
42
Q

How will a nurse promote safety with a patient who has alcoholism?

A
  1. assess client’s level of disorientation
  2. knowledge of the client’s level of cognitive functioning is essential
  3. obtain drug hx, urine, blood samples
  4. Place the client in a quiet private room (not alone if excessive hyperactivity or suicidal ideation
  5. Frequently orient the client to reality and the environment
  6. Assess blood alcohol level
  7. Monitor VS every 15 minutes until stable
43
Q

How would a nurse promote participation in treatment for a patient with alcoholism?

A
  1. be genuine, honest, and respectful of the client
  2. convey an attitude of acceptance
  3. identify maladaptive behaviors
  4. Do not accept the use of defense mechanisms
  5. Encourage the participation in therapeutic group activities
44
Q

How would a nurse promote healthy coping skills in a patient with alcoholism?

A
  1. establish a trusting nurse-client relationship
  2. set limits on manipulative behavior
  3. Maintain consistency in responses
  4. Encourage the client to verbalize feelings, fears, or anxieties
  5. explore methods of dealing with stressful situations other than resorting to alcohol use
45
Q

How would a nurse promote adequate nutrition for someone with alcoholism?

A
  1. administer vitamins, dietary supplements as ordered
  2. Monitor lab work
  3. Collaborate with a dietitian
  4. Document I&O and calorie count
  5. Weight client daily if necessary
  6. Teach the importance of adequate nutrition
46
Q

How would a nurse promote healthy self-esteem?

A
  1. spend time with the client
  2. encourage the client to accept responsibility for their own behaviors and feelings
  3. Encourage the client to focus on strengths and accomplishments
  4. encourage participation in therapeutic group activities
  5. Teach assertiveness techniques
47
Q

What are some nursing interventions for education with a patient who has alcoholism?

A
  1. assess client’s level of knowledge and readiness to learn
  2. develop a teaching plan that includes measurable objectives
  3. include significant others if possible
  4. begin teaching with complete concepts
  5. use interactive teaching strategies
  6. teach about the effects of alcohol
48
Q

What should a nurse do regarding hallucinations or delusions with alcoholism?

A

Do not argue with the client experiencing delusions or hallucinations; convey acceptance that the client believes the situation, but you do not see or hear what is not there