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Psych Nursing > Ch 14: Drug Abuse > Flashcards

Ch 14: Drug Abuse Flashcards

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1
Q

Need for increasing amounts to produce the desired effects

A

physical dependence

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2
Q

Overwhelming desire to repeat the use of a particular drug to produce pleasure or avoid discomfort

A

psychological dependence

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3
Q

describe substance abuse disorder

A

Use of the substance interferes with ability to fulfill role obligations
Attempts to cut down or control use fail
Intense craving for the substance
Excessive amount of time spent trying to procure the substance or recover from its use

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4
Q

Development of a reversible syndrome of symptoms following excessive use of a substance
Direct effect on the central nervous system
Disruption in physical and psychological functioning
Judgment is disturbed and social and occupational functioning is impaired.

A

substance intoxication

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5
Q

Development of symptoms that occurs upon abrupt reduction or discontinuation of a substance that has been used
Symptoms are specific to the substance that has been used.
Disruption in physical and psychological functioning

A

substance withdrawal

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6
Q

Classes of Psychoactive Substances

A

Alcohol, Caffeine, Cannabis, Hallucinogens, Inhalants, Opioids, Sedatives/hypnotics, Stimulants, Tobacco

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7
Q

biochemical factor of alcohol addiction

A

Alcohol may produce morphine-like substances in the brain that are responsible for alcohol addiction.

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8
Q

is alcoholism genetic

A

yes

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9
Q

psychological factors for addiction/alcoholism

A

Punitive superego

Fixation in the oral stage of psychosexual development

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10
Q

sociocultural factors of addiction

A

social learning, conditioning, cultural influences

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11
Q

phase one of alcohol use disorder

A

Prealcoholic phase: Characterized by use of alcohol to relieve everyday stress and tensions of life

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12
Q

phase two of alcohol use disorder

A

Early alcoholic phase: Begins with blackouts—brief periods of amnesia that occur during or immediately following a period of drinking; alcohol is now required by the person.

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13
Q

phase three of alcohol use disorder

A

The crucial phase: Person has lost control; physiological dependence is clearly evident.

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14
Q

phase four of alcohol use disorder

A

The chronic phase: Characterized by emotional and physical disintegration. The person is usually intoxicated more often than sober

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15
Q

Peripheral neuropathy, characterized by

A 
Peripheral nerve damage
Pain
Burning
Tingling
Prickly sensations of the extremities
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16
Q

Thought to result from same B vitamin deficiency that contributes to peripheral neuropathy

A

alcoholic myopathy

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17
Q

Sudden onset of muscle pain, swelling, and weakness; reddish tinge to the urine; rapid rise in muscle enzymes in the blood

A

acute myopathy

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18
Q

Gradual wasting and weakness in skeletal muscles

A

chronic myopathy

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19
Q

Most serious form of thiamine deficiency in alcoholic patients

A

Wernicke’s encephalopathy

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20
Q

Syndrome of confusion, loss of recent memory, and confabulation in alcoholic patients

A

Korsakoff’s psychosis

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21
Q

Effect of alcohol on the heart is an accumulation of lipids in the myocardial cells, resulting in enlargement and a weakened condition.

A

alcoholic cardiomyopathy

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22
Q

Inflammation and pain in the esophagus

A

esophagitis

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23
Q

Effects of alcohol on the stomach include inflammation of the stomach lining characterized by epigastric distress, nausea, vomiting, and distention

A

gastritis

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24
Q

Usually occurs 1 or 2 days after a binge of excessive alcohol consumption. Symptoms include constant, severe epigastric pain; nausea and vomiting; and abdominal distention.

A

acute pancreatitis

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25
Q

Leads to pancreatic insufficiency resulting in steatorrhea, malnutrition, weight loss, and diabetes mellitus

A

chronic pancreatitis

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26
Q

Caused by long-term heavy alcohol use
Symptoms: Enlarged, tender liver; nausea and vomiting; lethargy; anorexia; elevated white blood cell count; fever; and jaundice. Also ascites and weight loss in severe cases

A

alcoholic hepatitis

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27
Q

end-stage of alcoholic liver disease and is believed to be caused by chronic heavy alcohol use. There is widespread destruction of liver cells, which are replaced by fibrous (scar) tissue

A

Cirrhosis of the liver

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28
Q

Complications of cirrhosis of the liver can include

A

Portal hypertension
Ascites
Esophageal varices
Hepatic encephalopathy

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29
Q

Impaired production, function, and movement of white blood cells

A

leukopenia

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30
Q

Platelet production and survival are impaired as a result of the toxic effects of alcohol

A

thrombocytopenia

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31
Q

Alcohol use during pregnancy can result in

A

fetal alcohol spectrum disorders (FASDs)

32
Q

what can fetal alcohol syndrome cause

A

Problems with learning, memory, attention span, communication, vision, and hearing
Alcohol-related neurodevelopmental disorder
Alcohol-related birth defects

33
Q

Alcohol intoxication

A

Occurs at blood alcohol levels between 100 and 200 mg/dL

34
Q

when does alcoholic withdrawal occur

A

Occurs within 4 to 12 hours of cessation of or reduction in heavy and prolonged alcohol use

35
Q

what substances are used in Sedative/hypnotic use disorder

A

Barbiturates
Nonbarbiturate hypnotics
Antianxiety agents
Club drugs

36
Q

effects of sedative/hypnotic use disorder

A 
Effects on sleep and dreaming
Respiratory depression
Cardiovascular effects
Renal function
Hepatic effects
Body temperature
Sexual functioning
37
Q

With these central nervous system (CNS) depressants, effects can range from disinhibition and aggressiveness to coma and death (with increasing dosages of the drug).

A

intoxication

38
Q

Severe withdrawal from CNS depressants…

A

can be life threatening

39
Q

substances used in stimulant use disorder

A 
Amphetamines
Synthetic stimulants
Non-amphetamine stimulants
Cocaine
Caffeine
Nicotine
40
Q

stimulant use disorder effects

A

CNS, cardiovascular, pulmonary, renal/GI, sexual

41
Q

Amphetamine and cocaine intoxication produce

A

euphoria, impaired judgment, confusion, and changes in vital signs (even coma or death, depending on amount consumed).

42
Q

Caffeine intoxication usually occurs following

A

consumption in excess of 250 mg (causes restlessness and insomnia)

43
Q

Amphetamine and cocaine withdrawal may result in

A

dysphoria, fatigue, sleep disturbances, and increased appetite.

44
Q

Withdrawal from caffeine may include

A

headache, fatigue, drowsiness, irritability, muscle pain and stiffness, and nausea and vomiting

45
Q

Withdrawal from nicotine may include

A

dysphoria, anxiety, difficulty concentrating, irritability, restlessness, and increased appetite

46
Q

symptoms of inhalant disorder

A

Dizziness, ataxia, muscle weakness
Euphoria, excitation, disinhibition, slurred speech
Nystagmus, blurred or double vision
Psychomotor retardation, hypoactive reflexes
Stupor or coma

47
Q

when does intoxication of inhalants occur

A

shortly after use of or exposure to inhalant

48
Q

Severe opioid intoxication can lead to

A

respiratory depression, coma, and death

49
Q

withdrawal From short-acting drugs (e.g., heroin)

A

Symptoms occur within 6 to 8 hours, peak within 1 to 3 days, and gradually subside in 5 to 10 days

50
Q

withdrawal From long-acting drugs (e.g., methadone)

A

Symptoms occur within 1 to 3 days, peak between days 4 and 6, and subside in 14 to 21 days.

51
Q

withdrawal From ultra-short-acting meperidine

A

Symptoms begin quickly, peak in 8 to 12 hours, and subside in 4 to 5 days

52
Q

symptoms of opiod withdrawal

A

Dysphoria, muscle aches, nausea/vomiting, lacrimation or rhinorrhea, pupillary dilation, piloerection, sweating, abdominal cramping, diarrhea, yawning, fever, and insomnia

53
Q

physiological effects of hallucinogens

A

NV, pupil dilation, increased BP and pulse, loss of appetite, insomnia, increased blood sugar, decreased respirations

54
Q

Symptoms of phencyclidine intoxication

A

belligerence and assaultiveness, and may proceed to seizures or coma.

55
Q

how long does impairment of motor skills following cannabis last

A

8-12 hrs

56
Q

symptoms of cannabis intoxication

A

conjunctival injection, increased appetite, dry mouth, tachycardia

57
Q

what is the legally intoxicated level

A

0.08 % BAL

58
Q

when does alcohol withdrawal occur

A

4-12 hours after cessation

59
Q

this is an excellent tool that is used by many hospitals to assess risk and severity of withdrawal from alcohol
used for initial assessment as well as ongoing monitoring of alcohol withdrawal symptoms

A

Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA)

60
Q

these are another screening tool to determine if an individual has problem with substances
some psychiatric units administer this to all clients to determine if there is a dual diagnosis

A

CAGE Questionnaire and Michigan Alcoholism Screening Test (MAST)

61
Q

what are the four main parts of the CAGE

A

Cut down?
Annoyed you?
Guilty?
Eye opener?

62
Q

Clients with a coexisting substance disorder and mental disorder may be assigned to a special program that targets the dual diagnosis.
Program combines special therapies that target both problems.

A

dual diagnosis

63
Q

It is estimated that 10 to 15 percent of nurses suffer from

A

disease of chemical dependency

64
Q

_______ is the most widely abused drug, followed closely by ________

A

alcohol; narcotics

65
Q

state board response to chemically impaired nurse

A

May deny, suspend, or revoke a license based on a report of chemical abuse by a nurse

66
Q

allow impaired nurses to avoid disciplinary action by agreeing to seek treatment.

A

diversionary laws

67
Q

Defined by dysfunctional behaviors that are evident among members of the family of a chemically dependent person, or among family members who harbor secrets of physical or emotional abuse, other cruelties, or pathological conditions

A

codependency

68
Q

Keeps feelings in control, and often releases anxiety in the form of stress-related illnesses, or compulsive behaviors such as eating, spending, working, or use of substances

A

codependency

69
Q

classic characteristics of codependent nurse

A

Caretaking
Perfectionism
Denial
Poor communication

70
Q

recovery process of codependence

A

Survival stage
Re-identification stage
Core issues stage
Reintegration stage

71
Q

A major self-help organization for the treatment of alcoholism

A

alcoholics anyonymous

72
Q

what is AA based on

A

Peer support
Acceptance
Understanding from others who have experienced the same problem

73
Q

pharmacology for alcoholism

A 
Disulfiram (Antabuse) *
Acamprosate (Campral) *
Naltrexone (ReVia)
Nalmefene (Revex)
Selective serotonin reuptake inhibitors (SSRIs)
74
Q

what is used in substitution therapy

A

activan and valium

75
Q

psychopharmacology for alcohol

A

Benzodiazepines
Anticonvulsants
Multivitamin therapy
Thiamine

76
Q

pharmacology for opiods

A

Narcan and Clonidine and Methadone

77
Q

psychopharmacolgy for stimulants

A

Minor tranquilizers
Major tranquilizers
Anticonvulsants
Antidepressants

Psych Nursing (21 decks)

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