alcohol and drugs/ Aminoglycosides,

Question 1

If the patient denys alcohol abuse you

Answer 1

confront

Question 2

if a patient denys loss you

Answer 2

support

Question 3

denial

Answer 3

1 problem with abuse

Question 4

Alcoholism

Answer 4

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

Question 5

dependency

Answer 5

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

Question 6

co-dependency

Answer 6

• 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

Question 7

manipulation

Answer 7

• 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

Question 8

wernicke korsakoff

Answer 8

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

Question 9

S/s of wernicke korsakoff

Answer 9

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

Question 10

tx of wernicke korsakoff

Answer 10

• 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

Question 11

aversion therapy

Answer 11

• 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

Question 12

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

Answer 12

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

Question 13

what can they have when on aversion therpay

Answer 13

• red wine vinaigrette

Question 14

how to know if its dependancy or manipulation

Answer 14

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

Question 15

stages of loss and grief

Answer 15

1. denial
2. anger
3. bargaining
4. depression
5. expectance

Question 16

dependency and manipulation also known as `

Answer 16

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

Question 17

most abused drug that isn’t upper or downer

Answer 17

• laxatives

Question 18

What are uppers

Answer 18

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

Question 19

What are downers

Answer 19

• Heroin
• Marijuana
• Alchohol
• Benzos
• everything that isnt an upper

Question 20

s/s of uppers

Answer 20

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

Question 21

s/s of downers

Answer 21

• everything goes down
• lethargy
• respiratory depression
• bradycardia
• bradypnea

Question 22

s/s of baby born addicted to downers

Answer 22

• shrill high pitched cry

Question 23

questions to ask your self with addiction

Answer 23

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

Question 24

withdrawl in upper

Answer 24

• not enough upper
• everything goes down

Question 25

withdrawal in downer

Answer 25

- not enough downer - everything goes up

Question 26

overdose in upper

Answer 26

- too much upper - everything goes up

Question 27

overdose in downer

Answer 27

- too much downer - everything goes down

Question 28

when is respiratory depression biggest risk in regards to addiction

Answer 28

- downer overdose and upper withdrawal

Question 29

when is seizure biggest risk in regards to addiction

Answer 29

- overdose upper and withdrawal downer

Question 30

alchohol withdrawal

Answer 30

- every alcoholic goes through this - within 24 hours of last drink - not life threatening to self or others

Question 31

tx of alcohol withdrawal

Answer 31

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

Question 32

to get delirium tremens...

Answer 32

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

Question 33

Delirum Tremens

Answer 33

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

Question 34

tx DT

Answer 34

- 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

Question 35

Drug addiction in newborns

Answer 35

- AlwaSY assume intoxication (overdose) not withdrawal at birth - Baby has to be 24 hours old to go through withdrawal

Question 36

S/S of withdrawl in newborn

Answer 36

- difficult to console - exaggerated startle reflex - seizure risk - shrill high pitched cry - + same as upper and downer rules

Question 37

Aminoglycosides

Answer 37

- 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)

Question 38

not mean Aminoglycosides

Answer 38

- arithromyacin - zythromycin - clarithromycin

Question 39

administration of Aminoglycosides

Answer 39

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

Question 40

watch out for what with Aminoglycosides

Answer 40

- 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

Question 41

when to give Aminoglycosides orally

Answer 41

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

Question 42

Aminoglycosides for hepatic enchepalopathy

Answer 42

- 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

Question 43

Aminoglycosides for pre op bowel surgery to sterilize the bowl

Answer 43

- give oral - oral mycins will kill gram negative bacteria in you gut

Question 44

why draw peak and troughs

Answer 44

- on drugs that have narrow therapeutic window like digoxin and Aminoglycosides

Question 45

trough

Answer 45

- when drug is at its lowest - 30 minutes before next dose

Question 46

order of drawing peak and trough and giving medicine

Answer 46

- draw trough, give drug, draw peak (TAP)

Question 47

peak

Answer 47

- 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