Alcoholism Flashcards
The #1 psychological problem in abuse disorders is…
DENIAL
Response/Treatment for denial
Confront them and point out difference between what they say and do
When is denial okay?
Loss/grief
5 stages of grief
DABDA
Denial
Anger
Bargaining
Depression
Acceptance
Denial is a loss situation you…
support pt
Denial in an abusive situation you…
confront pt
2 psych problem in abuse situations is…
co-dependency or dependency
dependency
The abuser is dependent (gets free ride/freedom from responsibilities)
partner does things and makes decisions for them
co-dependency
Partner is co-dependent
increases self esteem when doing things/making decisions for abuser
dependency treatment
dependents are abusers… confront them
co-dependency treatment
set limits & enforce them
agree on what requests are allowed then enforce
learn to say no
work on self esteems issues
Manipulation
when abuser gets partner to do things/make decisions that are not in best interest/harmful
manipulation treatment
set limits and enforce them
if task is not dangerous/neutral then its..
dependency or co-dependency
if task is dangerous/ harmful then its…
manipulation
How many pts in Denial?
1 pt
how many pts in dependency?
2 pts
how many pts in manipulation?
1 pt
Wernicke is…
encephalopathy
Korsakoff is…
psychosis
Psychosis induced by…
vit b1 deficiency, thiamine deficiency
pt looses touch with reality
s/sx of wernicke/korsakoff
amnesia & confabulation(making up stories: these lies are just as real as reality for them)
Dealing with Wernickie/Korsakoff confabulation
redirect pt and DO NOT present reality
Characteristics of W/K
- preventable… take B1
- arrestable (stop from getting worse)… take B1
- irreversible… causes brain damage
(pt doesnt have to stop drinking they just need vit B1)
Antabuse
Alcohol deterrent
Revia (disulfram)
antidote
Aversion therapy
behavior therapy designed to make pt give up habit by associating it with unpleasant affect
Onset/Duration
2 weeks for antabuse and revia
Antabuse/Revia teaching
avoid all forms of etoh b/c can lead to n/v and death
avoid items with alcohol (mouthwash, perfume, OTC liquid meds, elixir, hand sanitizer, bug repellent, vanilla extract, cupcake with unbaked icing)
Red wine vinagrettes does not have alcohol in it
Overdose/Withdrawal steps
- is it upper or downer
- is it overdose or withdrawal
if its not an upper than its a
downer
The 5 Uppers
- caffeine
- cocaine
- adderall
- PCP/LSD (psychadelics/halluncinogens)
- Methampethamines
Upper s/sx
Things go up!
euphoria, seizures, restlessness, irritability, hyperflexia, tachy anytthing, increased bowels (borboygmi), diarrhea
Downer s/sx
Things go Down!
lethargic, resp depression/arrest, constipation, brady anything
Highest Priority for Uppers
suctioning due to seizures
highest priority for downers
intubation/ventilation due to resp arrest/depression
Upper Overdose
Too much of an upper
everything goes up
seizure is highest concern
Upper withdrawal
Too little of the upper
everything goes down
resp depression highest concern
Downer OD
too much of a downer
everything goes down
resp depression highest concern
Downer Withdrawal
too little downer
everything goes up
seizure is highest concern
Drug abuse in newborn rules
Less than 24 hrs -> intoxication(overdose)
24 hrs + -> withdrawal
alcohol withdrawal syndrome
EVERY alcoholic goes through this 24 hrs after cease in drinking
Delirium Tremens
occurs about 72 hrs after cease in drinking
AWS & DT analogy
pee pee (AWS) always before poo poo (DT) but poo poo (DT) not always after pee pee (AWS)
AWS always comes before DT but DT doesnt always come after AWS
AWS care plan
24 hrs after last drink
non-life threatening
regular diet, semiprivate room, pt free to move around, no restraint
DT care plan
72 hrs after last drink
life threatening to others and self
NPO/clear liquid diet (seizures), private room near RN, bed rest, restraints (vest/2 pt lock)
AWS & DT meds
anti HTN
tranquilizer
multivitamin with B1
Aminoglycosides
Big gun of antibiotics ONLY used as last resort, unsafe at toxic levels
Aminoglycosides= A Mean Old Mysin
Treats Mean old infections
-serious, life threatening, gram negative
(TB, sepsis)
All Aminoglycosides end in
-mycin
(not all drugs ending in mycin are aminoglycosides)
If they have THRO in the middle throw them off the Mean Old Mycin list
These do not treat serious infections
(ex: aziTHROmycin)
Aminoglycoside side effects
Ototoxicity (monitor hearing, balance, tinnitus, CN8)
Nephrotoxicity (monitor Creatinine)
aminoglycoside Rule of 8
Toxic to CN8
administer every 8 hrs
Mean old mycins are not given PO except..
- hepatic encephalopathy to kill e.coli
- pre-op bowel surgery
1 action of oral mycin
Sterilize bowel
Who can sterilize the bowels
NeoKan
Neomycin
Kanamycin
Trough
when drugs are at the lowest concentration in blood
peak
when drugs are at highest concentration in blood
TAP level
Trough
Administer
Peak
Narrow therapeutic window/index
small difference in what works and what kills with a med
Troughs are drawn…
30 mins before next med dose
Peaks are drawn…
depending on the route of administration
Peak Sublingual
5-10 mins after dissolved
peak IV
15-30 mins after drug finished (bag empty)
peak IM
30-60 mins
peak subQ
depends on insulin
peak PO
not needed, not tested
Play price is right for drawing peaks
if 2 answers are correct go with the highest time without going over
