Alcohol Substance Abuse Flashcards

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1
Q

What are the two groups of substance related disorders?

A

Substance used disorder( addiction)

Substance induced disorders (in intoxication withdrawal delirium neural cognitive disorder, psychosis, bipolar, depressive OCD, anxiety, sexual dysfunction, and sleep disorders)

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2
Q

Define addiction

A

A compulsive or chronic requirement the need is so strong to generate distress either physical or physiological is left on fulfilled

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3
Q

What is substance addiction?

A

Use of a substance interferes with the ability to fulfill a role oblige
Attempts to cut down or control. Use fail.
It to cravings lead to excessive amount of time, but trying to pure substance or recover from its use
Causes difficulty interpersonal relationships become socially isolated is I’ll
Engages and hazardous activities
Tolerance develops
Substance specific symptoms occur upon discontinuation

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4
Q

What is tolerance

A

Addiction is evident when tolerance develops the amount required to achieve the desired effect continuously increases

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5
Q

Define intoxication

A

A state of disturbance and cognition, perception behavior, level of consciousness, judgment, and other functions that is directly attributed to the effects of psychoactive drug. It may be marketed by a physical and mental state of exhilaration and emotional frenzy or lethargy and stupor.

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6
Q

What is substance intoxication?

A

The development of a reversible syndrome of symptoms, following excessive use of of substance

The symptoms are drug specific in a occur shortly after ingestion of substance judgment is disturbed, resulting in inappropriate and maladaptive behavior, and social and occupational functioning or impaired

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7
Q

What is withdrawal?

A

The psychological and mental readjustment that accompanies the discontinuation of a addictive substance

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8
Q

What is substance withdrawal?

A

Occurs upon abrupt reduction or discontinuation of a substance used regularly over prolonged period of time

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9
Q

What does substance specific syndrome include?

A

Clinically significant physical signs and symptoms, as well as physiological changes, such as disturbances and thinking feeling and behavior

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10
Q

Which of the following has been implicated in the predisposition of substance-abuse
Hereditary factor
Fixation in the adolescent stage of psychosexual development
Punitive ego
Narcissistic, independent, personality traits

A

Hereditary factor

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11
Q

How is alcohol made?

A

It is a natural substance formed by a reaction of fermenting sugar with yeast spores

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12
Q

What is the amount present in a beer, wine and whiskey that is consumed at the same rate would have an equal effect on one’s body

A

12 ounces of beer 3 to 5 ounces of wine in a cocktail with 1 ounce of whiskey, all measuring a approximately 0.5 ounces

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13
Q

What effect does alcohol have on the central nervous system?

A

A depressant effect resulting in behavior and mood changes

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14
Q

What is phase 1 of alcohol used disorder

A

The pre-alcoholic phase

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15
Q

What is the pre-alcoholic phase phase 1 of alcohol used disorder

A

This phase is characterized by the use of alcohol to relieve the everyday stress intention of life

Children may have observed parents or other adults, drinking alcohol and enjoying the effects child learns alcohol is acceptable method of coping for stress

Tolerance develops in amount required to achieve the desire effect steadily increases

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16
Q

What is phase 2 of alcohol used disorder

A

The early alcoholic phase

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17
Q

What is phase 2 the early alcoholic phase of alcohol used disorder

A

Phase begins with blackouts, brief periods of amnesia that occurred, during or immediately following a period of drinking
Alcohol is no longer source of pleasure or relief, but a drug that is required by individual

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18
Q

What are some common behaviors in phase 2 the early alcoholic phase of alcohol used disorder

A

Sneaking drinks or secret drinking
Preoccupation with drinking and maintaining the supply of alcohol
Rapid gulping of drinks
Blackouts

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19
Q

How does someone feel during phase 2 the early alcoholic phase

A

Feels enormous guilt, and becomes very defensive about drinking excessive. Use of denial, and rationalization is

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20
Q

What is phase 3 of alcohol used disorder

A

The crucial phrase

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21
Q

What is phase 3 the crucial phase

A

Individual has lost control of use, and physiological addiction is clearly evident
Been described as inability to choose, whether or not to drink
Binge drinking occurs

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22
Q

What is binge drinking?

A

The pattern of drinking that brings blood alcohol concentration levels up to 0.08

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23
Q

How many drinks for men and women does it take for the blood alcohol level to reach 0.08

A

Four drinks for women and five drinks for men in about two hours

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24
Q

What are some characteristics of been shrinking?

A

Sickness
Loss of conscious
Squalor
Decoration

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25
Q

How does a patient feel in phase 3 the crucial phase of alcohol use disorder

A

Individual is extremely ill, anger and aggression or common manifestations
Drinking is total focus and is willing to risk losing everything that was once important to maintain the addiction

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26
Q

My phase 3 crucial phase what is not uncommon for the individual to experience

A

Loss of job, marriage, family, friends, and most especially self-respect

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27
Q

What is phase 4 of alcohol used disorder

A

The chronic phase

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28
Q

What is phase 4 the chronic phase of alcohol used disorder

A

Characterized by emotional and physical disintegration
Individual is usually intoxicated more often than he is sober

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29
Q

What is emotional disintegration evidenced by?

A

Profound helplessness, and self-pity

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30
Q

What happens to the body in phase 5 the chronic phase

A

Life-threatening, physical manifestations may be evident in virtually every system of the body

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31
Q

What does unmanaged withdrawal from alcohol resulting

A

Syndrome of symptoms that include hallucinations, tremors convulsion, severe agitation, and panic
Depression suicidal ideation are not uncommon

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32
Q

Can withdrawal from alcohol be fatal

A

Yes, for long-term heavy drinkers

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33
Q

At low-dose alcohol produces what kind of symptoms on the body

A

Relaxation loss of inhibitions, lack of concentration, drowsiness, slurred, speech, and sleep

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34
Q

What is peripheral neuropathy due to alcohol?

A

Characterized by nerve damage, results in pain, burning, tingling, or prickly sensation and extremities

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35
Q

What causes peripheral neuropathy in an alcoholic?

A

Direct result of deficiency in the B vitamins, particularly thiamine

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36
Q

Why is nutritional deficiencies common in chronic alcoholics?

A

Due to insufficient intake of nutrients, and because of toxic effective alcohol results in male absorption of nutrients

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37
Q

Is peripheral neuropathy reversible in alcoholics?

A

The process is often reversible with abstinence from alcohol and restoration of nutritional deficiencies

But for some individuals, pain and numbness may be permanent

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38
Q

If an alcoholic has peripheral neuropathy and continues the use of chronic alcohol, what will happen

A

Permanent muscle wasting and paralysis can occur

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39
Q

When does is alcoholic myopathy occur

A

May occur in acute or chronic condition

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40
Q

In acute alcoholic myopathy, what happens

A

Individual experiences of sudden onset of muscle pain, swelling and weakness, along with myoglobin urea evidence by red tinged in the urine

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41
Q

What can be elevated in alcohol alcoholic myopathy before the appearance of symptoms?

A

Creatinine kinase

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42
Q

What lab are elevated in alcoholic myopathy?

A

Creatinine phosophonokinase (CPK)
Lactate dehydrogenase (LDH)
Aldolase
Aspartame aminotransferase (AST)

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43
Q

In acute alcoholic myopathy, what happens to the muscles

A

Muscle symptoms are usually generalized but pain and swelling may be selective involved in the calves or other muscle groups

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44
Q

What are the symptoms of chronic alcoholic myopathy?

A

Gradual wasting and weakness and skeletal muscles

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45
Q

What is difference between acute and chronic alcohol of myopathy

A

The pain tenderness in elevated muscle enzymes seen an acute myopathy are not seen in the chronic condition

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46
Q

What is thought to be the cause of alcoholic myopathy

A

Say, vitamin B deficiency that contributes to peripheral neuropathy

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47
Q

What is Wickes’s encephalopathy in an alcoholic?

A

Represents the most serious form of thiamine deficiency and alcoholics

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48
Q

What are symptoms of Wornick’s encephalopathy and alcoholics?

A

Paralysis of the ocular muscles
Diplopia
Ataxia
Somnolence
Stupor

49
Q

Is wernickes encephalopathy fatal

A

If thiamine replacement therapy is not given quickly, dealth will ensure

50
Q

What is korsakoffs psychosis in alcoholics?

A

Identified by syndrome of confusion, loss of recent memory, and confabulation in alcoholics

51
Q

When is korsakoffs psychosis encountered in clients with alcoholism

A

If they are recovering from Wernickes encephalopathy

52
Q

What is treatment of? korsakoffs psychosis

A

Parenteral or oral thiamine replacement

53
Q

What is alcoholic cardiomyopathy?

A

The effect of alcohol on the heart is an accumulation of lipids in the myocardial cells, resulting in enlargement and weakened condition

54
Q

What are the clinical findings of alcoholic cardiomyopathy generally caused by?

A

Congestive heart failure, arrhythmia

55
Q

What are symptoms of alcoholic cardiomyopathy?

A

Include decreased exercise, tolerance, tachycardia, dyspnea, edema, palpitations, and nonproductive cough

56
Q

What are laboratory test done to show alcoholic cardiomyopathy?

A

Elevation of enzymes CPK,AST, ALT, and LDH

57
Q

What tests are done to observe alcoholic cardiomyopathy

A

Electrocardiogram and congestive heart failure may be evident on chest x-rays

58
Q

What is the treatment of alcohol cardiomyopathy?

A

Total permanent abstinence from alcohol
Treatment of congestive heart failure may include rest, oxygen, sodium restriction, and diuretics

59
Q

What is esophagitis due to alcohol

A

Inflammation and pain in the esophagus occurs because of toxic effects of alcohol on the esophageal mucus, and because of frequent vomiting associated with alcohol abuse

60
Q

What is gastritis in an alcoholic?

A

Effects of alcohol in the stomach include inflammation of stomach lining
Alcohol breaks down the stomach, protective, mucus barrier, all allowing hydrochloric acid to erode the stomach wall

61
Q

What are some symptoms in gastritis of an alcohol?

A

Epigastric distress, nausea, vomiting, and distention
Damaged a blood vessels may result in hemorrhage

62
Q

What is acute pancreatitis of an alcoholic?

A

Occurs a day or two after a binge of excessive alcohol consumption

63
Q

What are symptoms of acute pancreatitis in an alcoholic

A

Constant, severe epigastric pain, nausea and vomiting and abdominal distention

64
Q

What is chronic pancreatitis in an alcoholic lead to?

A

Pancreatic insufficiency resulting in steatorrhea, male, nutrition, weight loss and diabetes mellitus

65
Q

What is alcoholic hepatitis?

A

Inflammation of the liver caused by long-term heavy alcohol use

66
Q

What are clinical manifestations of alcoholic hepatitis

A

Enlarged and tender liver, nausea and vomiting, lethargy anorexia, elevated white blood cell count, fever, jaundice sites, and weight loss

67
Q

What is treatment of alcoholic hepatitis?

A

Strict abstinence from alcohol, proper nutrition and rest the individual can experience complete recovery

68
Q

In severe cases of alcoholic hepatitis what happens

A

Can lead to cirrhosis or hepatic encephalopathy

69
Q

What is cirrhosis of the liver in an alcoholic?

A

Chronic injury to the liver. It is in stage of alcoholic liver disease in results from long-term chronic alcohol abuse.

There is a widespread destruction of liver cells which are replaced by scar tissue

70
Q

What are clinical manifestations of cirrhosis of the liver?

A

Nausea and vomiting, anorexia weight loss, abdominal pain, jaundice, edema anemia blood coagulation abnormalities

71
Q

What does treatment of cirrhosis of the liver include?

A

Abstinence from alcohol, correction of male, nutrition, supportive care to prevent complications of the disease

72
Q

What are complications of cirrhosis of the liver?

A

Porto hypertension
Ascites
Esophageal varices
Hepatic encephalopathy

73
Q

What is portal hypertension?

A

Elevation of blood pressure through the portal, circulation results from defective blood flow through the cirrhotic liver

74
Q

What is ascites

A

Excessive amount of serous fluid accumulates in the abdominal cavity occurs in response to portal hypertension
Increase pressure results in seepage of fluid from the service of of the liver into of abdominal cavity

75
Q

What is esophageal varices

A

Veins in the esophagus that become distended because of excessive pressure due to defective blood flow through the cirrhotic liver
As the pressure increases the veracities rupture resulting in hemorrhage, and sometimes death

76
Q

What is hepatic encephalopathy?

A

Serious complication occurs in the response to the inability of the diseased liver to convert ammonia to urea for excretion

77
Q

What happens in a hepatic encephalopathy when there is a rise in serum ammonia?

A

Results in progressively, impaired mental functioning, apathy, euphoria, or depression, sleep disturbances, increased confusion in progression To coma, and eventually death

78
Q

What is the treatment include in hepatic encephalopathy?

A

Complete abstinence from alcohol, reduction of protein and diet avoidance of medication’s broken down in the liver or medication with ammonium (anti acids Tums)

79
Q

How do you reduce intestinal ammonia with medication

A

Neomyocin
Rifaximin
Laculose

80
Q

What is leukopenia from alcohol

A

Production function and movement of the white blood cells are impaired in chronic alcoholics

81
Q

What does leukopenia in alcoholics place the individual at high risk for

A

Contracting, infectious disease and complicated recovery

82
Q

What is thrombocytopenia in alcohol?

A

Completely production and survival are impaired as result of toxic effects of alcohol

83
Q

What does thrombocytopenia increase the risk for in alcoholics

A

Hemorrhage
Abstinence from alcohol rapidly reverse this deficiency

84
Q

How does alcohol interfere with sexual dysfunction?

A

Alcohol interferes with normal production and maintenance of female and male hormones, and long-term alcohol use can interfere with the Livers ability to metabolize estrogenic compounds

85
Q

For women and men what does sexual dysfunction from alcoholism mean?

A

For women, this can mean changes in menstrual cycle and decrease in loss of fertility
For men altered hormone levels, results in diminished libido, decreased sexual performance, and impaired fertility

86
Q

A client is brought to the emergency department. The client is aggressive has slurred speech and impaired motor coordination. Blood alcohol level is 347 among the physicians orders is thiamine which rational is for this intervention.
To prevent nutritional deficits
To prevent pancreatitis
To prevent alcoholic hepatitis
To prevent wernickes encephalopathy

A

To prevent wernickes encephalopathy

87
Q

When does alcohol intoxication occur?

A

Intoxication usually occurs at a blood alcohol level between 100 and 200 mg
Death has been reported at levels, ranging from 400 to 700

88
Q

What are some symptoms of alcoholic intoxication

A

Disinhibition of sexual or aggressive, impulsive mood, liability, impaired judgment, impaired social, or occupational functioning, slurred speech in coordination, unsteady gate nystagmus and a flushed face

89
Q

What are some symptoms of alcohol and intoxication

A

This inhibition of sexual or aggressive impulses, mood, liability, impaired judgment, impaired social in occupational functioning, slurred, speech, coordination, unsteady, flush face, and nystagmus

90
Q

When does alcohol withdrawal occur?

A

Within 4 to 12 hours of cessation or reduction in heavy and prolonged alcohol use
Several days or longer

91
Q

What are some withdrawal symptoms of alcohol?

A

Corey, tremor of hands, tongue or eyelids, nausea, vomiting, malaise, or weakness, tachycardia, sweating, elevated blood pressure, anxiety, depressed mood or irritability, transient, hallucinations, illusions, headache, insomnia

92
Q

When does alcohol withdrawal delirium occur?

A

On the second or third day, following decrease or discontinuation of alcohol

93
Q

What are CNS depressants?

A

Alcohol, barbiturates, and non-barbiturates

94
Q

What are CNS stimulants

A

Amphetamines and related drugs
Cocaine
Synthetic stimulants

95
Q

It’s estimated that what percentage of nurses have substance abuse disorders

A

10% alcohol is most widely abused, drug fellow closely by narcotics

96
Q

What are some clues for recognizing substance impairment and nurses?t

A

High absenteeism if the person source is outside the work area
Rarely missing work if substance sources at
Increase in wasting drugs, higher incidents of incorrect narcotic counts, and higher record of signing out drugs for other nurses
Poor concentration, difficulty meeting, deadlines, inappropriate responses, poor memory recall
Inappropriate responses irritability
Isolating behaviors
Excuses for behaviors
Unkept appearance
Impaired motor coordination
Problems with relationship

97
Q

Actions taken by state boards relating to chemically abuse by nurse may include

A

Denial suspension, or revocation of license
Successful completion of treatment program evidence of support group, attendance 12 step program read negative drug screens

98
Q

What did the American nurse association create to assist impaired nurses

A

Programs for nurses who are impaired by substance or psychiatric illnesses. Individual go to these programs and get peer assistance as an alternative to discipline from state board as long as the impaired nurse is adhering to requirements of program.

99
Q

What is codependency?

A

A dysfunctional relationship with oneself

100
Q

What are traits associated with codependency?

A

Taking care of others at the expensive ones needs
Feeling responsible or for fixing other peoples problems
Having low self-esteem
People pleasers

101
Q

What are the four stages in the recovery process for an individual with codependent personal?

A

Stage one survival stage
Stage two re-identification
Stage three the core issue
Stage four reintegration stage

102
Q

What are some treatments for alcoholics?

A

Alcoholics anonymous goal is to remain sober through mutual support in acceptance, and understanding from others, who have experienced same problems with their life

103
Q

What is a pharmacological treatment for alcohol?

A

Antabuse alcohol deterrent therapy

104
Q

How does disulfiram Antabuse work

A

Ingestion of alcohol, while taking Aunt abuse results in a syndrome of symptoms that produce sustainable discomfort for the individual, and even result in death if the blood alcohol level is high

105
Q

What are some symptoms of ant abuse, if you drink alcohol

A

Occurs within 5 to 10 minutes of ingestion of alcohol. Mild reaction can occur at blood levels as low as 5 to 10 mg symptoms are fully developed approximately 50 mg and may include flushed skin, throbbing and head and neck. Respiratory difficulty dizziness, nausea and vomiting sweating hyperventilation, tech, Ardea, hypotension, weakness, blurred vision, and confusion.

106
Q

If someone drinks 125 to 150 mg of alcohol on antabuse, what will happen

A

Severe reactions, including respiratory depression, cardiovascular collapse, arrhythmias, myocardial, and function, acute congestive, heart, failure, unconsciousness, convulsions, and death

107
Q

When can you administer antabuse?

A

When client Epstein from alcohol for at least 12 hours

108
Q

If Antabuse is discontinued, it is important for the client to understand what

A

The sensitivity to alcohol may last for as long as two weeks

109
Q

A person taking anatbuse should avoid what

A

All alcohol containing substances, including liquid, cough and cold preparation, vanilla extract, aftershave, lotions, colognes, mouthwash, nail polish remover, I propyl alcohol

110
Q

Is disulfiram a cure for alcoholism

A

No, but it provides a measure of control for the individual who desires to avoid impulse drinking

111
Q

What is vitamin replacement and alcohol use disorder

A

Multivitamin therapy in combination with daily injections or oral administration of thiamine

112
Q

What is medication assisted treatment in alcohol. Use dis.

A

Used to decrease intensity of symptoms in an individual who is withdrawing from or who is experiencing the effects of excessive use of alcohol and other drugs

113
Q

What is widely used as a drug and alcohol withdrawal?

A

Benzodiazepines administered and controlled dose to prevent adverse effects of alcohol withdrawal

114
Q

What are some common benzodiazepines used in alcohol withdrawal?

A

Librium, serax , lorazepam( Ativan)
And Dazipam (Valium)

115
Q

If a patient has liver disease, what benzo diazepam would you use?

A

Lorazepam (Ativan) or oxazapam (serax)

116
Q

Are anti-convulsants ever used in the treatment of alcohol withdrawal

A

Yes, carbamazepine valproic acid for gabapentin to prevent withdrawal seizures

117
Q

What narcotic antagonist is used in alcohol abstinence

A

Naltrexone for the treatment of alcohol addiction

118
Q

How does group therapy help in those who have abuse substances?

A

They are able to share their experiences with others going through similar problems. They’re able to see themselves in others, and thus confront their defenses about giving up the substances.

119
Q

The client diagnosed with chronic alcoholism says to the nurse. I’m tired of using what I want to stop. Is there a medication that can help me maintain sobriety about which medication with the nurse provide information
Carbamazepine (tegretol
Clonidine ( catapres)
Disulfirm (Antabuse)
Folick acid

A

AntAbuse.