Alcohol Flashcards
what is the #1 issue with abuse? how do you treat it?
- denial
- treat with confronting (point out the difference between what they think and what they do)
what type of denial should not be treated with confrontation? how should it be treated?
- denial r/t loss & grief
- tx: support it
define: dependency r/t abuse
- abuser gets SO to do things for them, abuser is dependent on SO
ex. call my boss for me
define: codependency r/t abuse
- SO derives positive self esteem by doing things or making decisions for the abuser
ex. “I’m a wonderful SO for calling their boss for them”
what is the treatment for dependency/co-dependency
- set limits & boundaries –> teach the SO to say “no”
- increase self-esteem of SO
define: manipulation
- when the abuser gets the SO to do things for them that aren’t in the SO’s best interest
- the nature of the act is dangerous or harmful
what is the key difference between dependency/co-dependency and manipulation
- dependency = neutral acts
- manipulation = harmful to SO & SO doesn’t get + self esteem from it
ex. an alcoholic parent asks their 17 year old daughter to go buy alcohol from them
ex. an alcoholic person asks their 59 year old SO to go buy their alcohol from them
- manipulation (illegal for a 17yo to buy alcohol for them)
- dependency
what is treatment for manipulation
- set limits & enforce “no”
what is wernicke’s and korsakoff
- wernicke’s = encephalopathy
- korsakoff = psychosis
- often occur together, but two separate things
what is wernicke’s and korsakoff induced by?
- vitamin B1 or thiamin deficiency
what are symptoms of wernicke’s and korsakoff
- loss of touch w reality
- amnesia (++ memory loss)
- confabulation (make up stories & believe its their reality)
what is treatment for wernicke’s and korsakoff
- redirect –> rechannel what they want but cannot do, into something they can
ex. the pt believes they need to go to the white house for work, rechannel it into watching the news on what’s happening in the whitehouse
what is a “bad way” to treat wernicke’s and korsakoff
- confront
- agree/disagree
- do not present reality, bc they can’t learn it
what are 3 characteristics of wernicke’s and korsakoff
- preventable
- arrestable
- irreversible
how can wernicke’s and korsakoff be preventable and arrestable
- taking vitamin B1
what is a type of aversion therapy for alcoholism
- disulfuram (antabuse)
how does disulfaram work?
- makes you ++ sick when you consume alcohol
what is the onset of disulfaram
- 2 weeks
what pt teaching should be provided r/t disulfaram
- avoid all forms of alcohol to avoid NV & sickness
- what has alcohol
what items should you teach pts on disulfaram to avoid
- mouthwash
- bug spray
- after shave
- perfume, cologne
- OTC meds that end in ___elixir
- alcohol based hand sanitizer
- uncooked icings (bc of vanilla)
- NOT red wine vinegar
every abused drug is either an…
- upper or down
what are the 5 upper abused drugs
- caffeine
- cocaine
- PSP/LSD
- adderol
- methamphetamines
what are S&S of pt’s using “upper” drugs
(everything goes up)
- euphoria
- restlessness
- irritable
- tachycardia
- diarrhea, borborygmi
- hyperreflexia (+3,+4)
- spastic
- resp. seizu
- seizure
- increased temp
what are examples of “downer” drugs
- anything thats not an upper
ex. dilaudid, morphine sulfate, fentanyl, ativan, barbs, alcohol, marijuana, etc.
what are S&S of “downer” drugs
- lethargic, difficult to arouse
- resp depression & resp arrest
- everything goes down
if a pt is ODing on an “upper” drug, what signs would you see? withdrawal?
- OD = everything up
- WD = everything down
if a pt is ODing on a “downer” drug, what signs would you see? withdrawal?
- OD = everything down
- WD = everything up
what is the #1 concern with a downer OD and an upper WD
- resp depression and arrest
what is the #1 concern with an upper OD and a down WD
- seizures
at birth or within the first 24 hours of birth, you should assume…
- intoxication
after 24 hours of birth, what do you assume?
- withdrawal
ex. you’re caring for a pt to a downer drug addicted mom 24 hrs after birth. what S&S would you expect to see?
- difficult to console
- increased startle reflex
- seizure risk
alcohol WD occurs when?
- in about 24 hr after stopping drinking
every alcoholic goes through _____, but only a minority goes through…
- every alcohol goes through WD
- minority go through delirium tremens
delirium tremens (DT) occurs when?
~72 hrs after drinking
alcohol withdrawal syndrome (AWS) always preceeds DT, but…
- DT does not always follow AWS
= if you have DT, you had AWS. but if you have AWS, doesn’t mean you’ll get DT
describe the severity between AWS and DT
- AWS: not life threatening
- DT: life threatening
describe the danger associated with AWS vs DT
- AWS: not a danger to self or others
- DT: danger to self & others
describe the difference in diet when caring for a pt with AWS vs DT
- AWS: regular diet
- DT: NPO or clear liquids (d/t seizure risk)
describe the difference in pt’s room when caring for a pt with AWS vs DT
- AWS: semi-private, anywhere
- DT: private & near nurses station (d/t danger to self & others)
describe the difference in mobility when caring for a pt with AWS vs DT
- AWS: regular
- DT: restricted bed rest
describe the difference in restraints when caring for a pt with AWS vs DT
- AWS: none
- DT: vest or 2 point (one arm & one leg opposite to the other)
what meds are used in the treatment of both AWS and DT
- antihypertensives (bc everything is up in withdrawal)
- tranquilizer
- multi vitamin with B1 (prevents wernicke and korsakoff)
what are aminoglycides
- powerful abx used for treating serious, life threatening, resistant, and gram (-) infections
all aminoglycides end in _______
_____mycin
what 3 drugs that end in mycin are not aminoglycides
- erythromycin
- zithromycin
- clarithromycin
(all end in ____thromycin)
what are 3 toxic effects of aminoglycides
- ototoxic
- nephrotoxic
- toxic to cranial nerve 8 (ear nerve)
what should be monitored with aminoglycides r/t ototoxic
- hearing
- tinnitus (ringing ears)
- dizziness/vertigo
what should be monitored with aminoglycides r/t nephrotoxic
- creatinine (24 hr is first choice, then serum Cr)
aminoglycides are given how often?
q8h
what route are aminoglycides given?
- IM or IV
why arent aminoglycides given PO?
- not absorbed = wouldn’t do anything
what function does given aminoglycides PO have?
- sterilizes the bowel
in what 2 situations are aminoglycides given PO?
- hepaticencephalopathy
- pre-op bowel surgery
what two aminoglycides are given PO?
- neomycin
- canamycin
(think: who can sterilize my bowel? neo can!)
in what situations is it important to draw trough and peaks?
- in meds with narrow therapeutic index
trough and peak draw times are based on?
- route, not drug
what are the trough draw times for all routes of med admin
- 30 min before next dose
what is the peak draw time for subling.
5-10 min after drug dissolved
what is the peak draw time for IV
15-30 min after drug finished
what is the peak draw time for IM
- 30-60 min after giving med
