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PCC4 > Addiction: Smoking Addiction/Substance Abuse in Pregnancy > Flashcards

Addiction: Smoking Addiction/Substance Abuse in Pregnancy Flashcards

1
Q

What is the pathophysiology of nicotine?

A
  1. stimulates nicotinic receptors in the brain to release dopamine and epinephrine causing vasoconstriction
  2. increases mental alertness, cognitive ability, eventually depresses those responses
  3. often have difficulty falling asleep because nicotine acts as a stimulant
  4. Nicotine dependence results from chronic use
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2
Q

What are some withdrawal symptoms of nicotine addiction?

A
  1. craving
  2. nervousness
  3. restlessness
  4. Irritability
  5. Impatience
  6. Increased hostility
  7. Insomnia
  8. Weight gain
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3
Q

How much does secondhand smoke exposure increase lung cancer risk?

A

by 20-30%

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4
Q

What are the risk factors for nicotine addiction?

A
  1. emotions
  2. social pressure
  3. lack of education
  4. Alcohol use
  5. age
  6. Lower socioeconomic status
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5
Q

What are some ways to prevent tobacco use?

A
  1. counter-advertising mass-media campaigns
  2. school-based tobacco use prevention policies and programs
  3. Community interventions that reduce tobacco advertising
  4. Higher costs for tobacco products through increased excise taxes
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6
Q

What are some signs and symptoms of tobacco/nicotine usage?

A
  1. increased risk for heart disease, cancers of many types, COPD, HTN, stroke, macular degeneration, cataracts, PVD
  2. Deep voice from trauma to vocal cords
  3. Chronic cough
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7
Q

What does nicotine replacement therapy involve?

A
  1. relieves physiological effects of withdrawal
  2. transdermal patches
  3. gums
  4. nicotine inhalers
  5. Nasal Sprays
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8
Q

What complementary therapy could be used to help stop smoking?

A
  1. hypnotherapy
  2. acupuncture
  3. Yoga
  4. Massage
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9
Q

What nursing interventions are there for patients who have a nicotine addiction?

A
  1. serve as a role model by not smoking
  2. provide education information regarding dangers of smoking
  3. Help make smoking socially unacceptable
  4. Suggest resources
  5. Help young adults recognize, resist marketing efforts of tobacco industry
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10
Q

What are some teratogens?

A
  1. pesticides, viruses, medications

2. tobacco, alcohol, and illicit drugs

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11
Q

When is the greatest risk for abnormalities if a pregnant woman is exposed to a teratogen?

A

during the first trimester

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12
Q

What are some substances that are commonly abused during pregnancy?

A
  1. caffeine (coffee, teas, colas, chocolate)
  2. alcohol
  3. cocaine and crack
  4. marijuana
  5. Phencyclidine
  6. MDMA (Ecstasy)
  7. Heroin
  8. Methadone
  9. Tobacco
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13
Q

What are some things to remember about alcohol being abused during pregnancy?

A
  1. birth defects related to exposure occur during the first 3-8 weeks of gestation
  2. Fetal alcohol spectrum disorders
  3. Maternal health can be affected
  4. Alcohol is excreted in breast milk
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14
Q

What are some things to remember about cocaine and crack being abused during pregnancy?

A
  1. powerful stimulant that acts at the nerve terminals to prevent the reuptake of dopamine and norepinephrine
  2. Results in Vasoconstriction, tachycardia, and HTN
  3. IV injection or snorting powdered form
  4. Crack can be smoked
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15
Q

What are some things to remember about marijuana being abused during pregnancy?

A
  1. no strong evidence marijuana has teratogenic effects on the fetus
  2. Associated with newborn’s increased startles and tremors
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16
Q

What are some things to remember about Phencyclidine (PCP) and MDMA abuse during pregnancy?

A

Phencyclidine (PCP): hallucinogen; causes confusion, delirium and feelings of euphoria

MDMA: produces euphoria; little is known about the effect on the fetus

17
Q

What are some things to remember about Heroin abuse during pregnancy?

A
  1. CNS depressant narcotic
  2. alters perception
  3. produces euphoria
  4. Fetus at increased risk for IUGR, meconium aspiration, and hypoxia
18
Q

What are some things to remember about methadone abuse during pregnancy?

A
  1. blocks withdrawal symptoms
  2. Reduces or eliminates craving for narcotics
  3. Neonatal abstinence syndrome
19
Q

What are some things to remember about tobacco abuse during pregnancy?

A
  1. Greater difficulty conceiving
  2. more likely to miscarry
  3. More likely to go into early labor and give birth prematurely
  4. Reduced birth weight
  5. Epigenetic studies indicated that maternal smoking alters fetal DNA and microRNA
20
Q

What are the risk factors for substance abuse during pregnancy?

A
  1. low attachment
  2. extreme economic deprivation
  3. family hx of problem behavior and management problems
  4. Family conflict and parental attitudes
  5. Alienation/rebellion
  6. Friends with problem behavior
  7. Favorable attitudes to problem behavior
  8. early initiate of problem behavior
  9. early/persistent antisocial behavior
  10. academic failure
  11. lack of commitment to school
21
Q

What are the classifications of medications for use during pregnancy?

A
  1. Category A: No associated fetal risk
  2. Category B: animal studies show no risk
  3. Category C: No adequate studies, or teratogenic effects in animals
  4. Category D: Evidence of human risk exists
  5. Category X: Fetal risks clearly outweigh possible benefits
22
Q

-What are some ways to prevent substance abuse during pregnancy?

A
  1. identify high-risk pregnant women, promote abstinence, refer to treatment, and follow-up
  2. Provide public education on hazards
  3. Facilitate training and education of professionals
23
Q

What are the clinical manifestations of cocaine abuse during pregnancy?

A
  1. placental abruption, fetal demise
  2. Cardiovascular and CNS effects
  3. Nasal and sinus diseases
24
Q

What are the clinical manifestations of alcohol abuse during pregnancy?

A
  1. increased risk of miscarriage/stillbirth
  2. low birth weight infant
  3. learning, attention, and language disorders
  4. Fetal alcohol syndrome
25
Q

What are the manifestations of nicotine abuse during pregnancy?

A
  1. miscarriage
  2. placental abruption
  3. PROM
  4. premature birth, low birth weight
  5. child may smoke later in life
  6. premature aging of the placenta
  7. arterial spasm
  8. polycythemia in the fetus

PCC4 (38 decks)

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