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NCLEX > alcohol and drugs/ Aminoglycosides, > Flashcards

alcohol and drugs/ Aminoglycosides, Flashcards

1
Q

If the patient denys alcohol abuse you

A

confront

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2
Q

if a patient denys loss you

A

support

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3
Q

denial

A

1 problem with abuse

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4
Q

Alcoholism

A
  1. confront the: point out the difference from what they say and what they do
  2. set limits and say no
  • dont say you say I
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5
Q

dependency

A
  • abuser gets to keep using
  • abuser is dependent on spouse to do things for them
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6
Q

co-dependency

A
  • significant other feels positive self esteem from supporting the abuser
  • harder to treat because spouse feels good for helping
  • Set limits and say no
  • work on self esteem of spouse
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7
Q

manipulation

A
  • abuser gets significant other to do things for him/her that is not in the best interest for the significant other
  • the nature of the act is dangerous or harmful
  • manipulation is easier to treat than dependency because there is no positive self esteem issue
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8
Q

wernicke korsakoff

A
  • encephalopathy and psychosis
  • alcoholic specific
  • psychosis induced by lack of vit B1/thiamine deficiency
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9
Q

S/s of wernicke korsakoff

A
  • amnesia with confabulation (memory loss with making up stories)
  • may loose entire decades of memory
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10
Q

tx of wernicke korsakoff

A
  • don’t confront them or present reality because they believe what they are saying
  • redirect them
  • to prevent or stop from getting worse: take vit B1
  • they dont have to stop drinking and it is reversible
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11
Q

aversion therapy

A
  • helps you to stop drinking
  • Antabuse (disufiram) and ReVia (naltrexone)
  • takes two weeks to get into the system
  • needs two weeks to get out of the system to safely drink again
  • teach pt to avoid all alchohol products
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12
Q

things to avoid while on aversion therapy to avoid N/V and death

A
  • mouthwash
  • aftershave
  • perfumes/colonge
  • insect repellant
  • anything that ends in elixir
  • achohol based hand sani
  • unbaked icing (vanilla extract)
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13
Q

what can they have when on aversion therpay

A
  • red wine vinaigrette
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14
Q

how to know if its dependancy or manipulation

A

-dependancy: if what spouse is doing has no harm no foul to them
- manipulation: if it is harmful to sig. other

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15
Q

stages of loss and grief

A
  1. denial
  2. anger
  3. bargaining
  4. depression
  5. expectance
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16
Q

dependency and manipulation also known as `

A
  1. dependancy: neutral: dependancy/co dependancy has 2 patients
  2. manipulation: negative: has 1 pt
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17
Q

most abused drug that isn’t upper or downer

A
  • laxatives
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18
Q

What are uppers

A
  • caffeine
  • Cocaine
  • PCP/LSD (hallucinogens)
  • Methamphetamines
  • Adderal: ADD drug
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19
Q

What are downers

A
  • Heroin
  • Marijuana
  • Alchohol
  • Benzos
  • everything that isnt an upper
20
Q

s/s of uppers

A
  • make things go up
  • euphoria
  • Tachycardia
  • tachypnea
  • restlessness
  • irritability
  • borborygmi (diarrhea)
  • reflexes 3+/4+ (spastic)
  • seizure
21
Q

s/s of downers

A
  • everything goes down
  • lethargy
  • respiratory depression
  • bradycardia
  • bradypnea
22
Q

s/s of baby born addicted to downers

A
  • shrill high pitched cry
23
Q

questions to ask your self with addiction

A
  1. is it an upper or downer drug?
  2. is the question asking about overdose (too much) or withdrawal (not enough)?
24
Q

withdrawl in upper

A
  • not enough upper
  • everything goes down
25
Q

withdrawal in downer

A
  • not enough downer
  • everything goes up
26
Q

overdose in upper

A
  • too much upper
  • everything goes up
27
Q

overdose in downer

A
  • too much downer
  • everything goes down
28
Q

when is respiratory depression biggest risk in regards to addiction

A
  • downer overdose and upper withdrawal
29
Q

when is seizure biggest risk in regards to addiction

A
  • overdose upper and withdrawal downer
30
Q

alchohol withdrawal

A
  • every alcoholic goes through this
  • within 24 hours of last drink
  • not life threatening to self or others
31
Q

tx of alcohol withdrawal

A
  • regular diet
  • semi private room anywhere on unit
  • up ad lib (go anywhere they want)
  • no restraints
  • meds: antihypertensives, tranquilizer, vitamin B1
32
Q

to get delirium tremens…

A

HAVE to get alcohol withdrawal but just because you have alchohol withdrawal doesn’t mean you will get delirium termens

33
Q

Delirum Tremens

A
  • unstabel!!! not for LPN
  • go into this within 72 hours of last drink
  • can kill you
  • DT is dangerous to self and others
34
Q

tx DT

A
  • NPO/clear liquids (seizure risk)
  • private room near nurse station
  • strict bed rest
  • need bed pans and urinals
  • restrained: vest or 2 point locked leathers (opposite arm and leg) rotate Q 2 hours
  • meds:antihypertensives, tranquilizer, vitamin B1
35
Q

Drug addiction in newborns

A
  • AlwaSY assume intoxication (overdose) not withdrawal at birth
  • Baby has to be 24 hours old to go through withdrawal
36
Q

S/S of withdrawl in newborn

A
  • difficult to console
  • exaggerated startle reflex
  • seizure risk
  • shrill high pitched cry
    • same as upper and downer rules
37
Q

Aminoglycosides

A
  • powerful class of ABX
  • “a mean old mycin for a mean old infection”
  • used for: life threatening, resistant, serious, and gram negative infections (liKE TB, spesis, pyelonephritis)
  • all end in mycin but not all that end in mycin are mean (if has thro, its not mean)
38
Q

not mean Aminoglycosides

A
  • arithromyacin
  • zythromycin
  • clarithromycin
39
Q

administration of Aminoglycosides

A
  • administer them Q 8 hours
  • IM or IV
  • DONT GIVE PO for infection because they are not absorbed and will go right through you
40
Q

watch out for what with Aminoglycosides

A
  • ototoxcicty (cranial nerve 8) and nephrotoxicity
  • think mice have large ears and they are shaped like a kidney
  • monitor for hearing loss, tinnitus, vertigo/dizziness
  • monitor creatinine
41
Q

when to give Aminoglycosides orally

A
  1. hepatic enchepalopathy/hepatic coma/liver coma
  2. pre op bowel surgery to sterilize the bowl
42
Q

Aminoglycosides for hepatic enchepalopathy

A
  • give oral
  • when the ammonia level gets to high and starts affecting brain
  • this will kill the e coli in the gut and lower the ammonia levels
  • will not harm damaged liver since not absorbed
43
Q

Aminoglycosides for pre op bowel surgery to sterilize the bowl

A
  • give oral
  • oral mycins will kill gram negative bacteria in you gut
44
Q

why draw peak and troughs

A
  • on drugs that have narrow therapeutic window like digoxin and Aminoglycosides
45
Q

trough

A
  • when drug is at its lowest
  • 30 minutes before next dose
46
Q

order of drawing peak and trough and giving medicine

A
  • draw trough, give drug, draw peak (TAP)
47
Q

peak

A
  • SL: 5-10 mintes after dissolves
  • IV: 15-30 minutes after drug finished
  • IM: 30-60 minutes after give drug
  • SQ: see insulins
  • PO: forget about it

NCLEX (15 decks)

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