Ch 48 mental health Flashcards
- know when alcoholism was recognized as a disease
1956
- know the genetic link related to alcoholism pg 1108
50%
- know the circumstances that increase risk for substance use disorders pg 1108
Having parents who use or used drugs and alcohol, have psychiatric disorders, live in areas of poverty and violence, have easy access to substances
use of a psychoactive substance in a nontherapeutic manner or illicit use of prescription drugs
abuse
Presence of physical and psychological symptoms of addiction
dependence
craves or feels compelled to use a substance to feel good
Psychological dependence:
needs the substance to prevent symptoms of withdrawal, not merely to sustain the feeling of euphoria that was present with early use of the drug
Addiction or physical dependence
need for increased amounts of substances to achieve the desired effect
tolerance
stopping the drug results in a group of symptoms
withdrawal
- know what a psychoactive substance is pg1109
Are any mind altering agents capable of changing a person’s mood, behavior, cognition, level of consciousness, or perceptions
- know those specific substances related to substance use disorder
Alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, stimulants, tobacco
- know diagnosing a substance use disorder pg1109
Within a 12-month period, the individual repeatedly demonstrates symptoms such as failure to meet usual obligations, creates danger to self or others, has legal problems, or has poor interpersonal relationships because of a substance use. Mild substance use disorder requires two to three symptoms.
- know dual diagnosis pg1109
Indicates that a patient has been diagnosed with a substance use problem as well as a mental health disorder
- know the signs and symptoms of substance abuse disorder, what to look for
track marks, poor condition of the skin, staggering gait, bruises, excessive perspiration, excoriation, malnutrition
ignoring reality and refusing to be swayed by evidence
Denial
justifying a behavior or action by making an excuse or an explanation
Rationalization
- The signs and symptoms of substance abuse in health care workers pg1109
Frequently calling in sick or always working, performing inadequate patient care, frequently leaving for breaks, offering to give pain medications, and a trend of patients reporting no relief after receiving pain medications
- Know the feelings experienced by family members pg 1109-1110
Anger, rage, embarrassment, guilt, shame, hopelessness, denial, rationalization
involves allowing a person to continue in the behavior of using substances by lessening consequences for the behavior
Enabling
overcompensates and tries to fix the situation or to control the person who uses substances
Codependent
- Know polysubstance abuse pg1111
Concurrent abuse of other substances as well has DOC
- Know alcohol metabolism and the servings of alcohol
A 12-oz bottle of beer, a 6-oz glass of wine, and a 1.5-oz single shot of whiskey contain the same amount of alcohol. It takes approximately 1 hour for the body to metabolize one standard drink. A number of facts can affect intoxication, such as the type of alcohol consumed, the quantity and speed of ingestion, whether food was consumed concurrently, the person’s history of alcohol use, general health status, and concurrent use of other drugs or substances that depresses the CNS.
- Know symptoms of alcohol intoxication
Drowsiness, slurred speech, loss of coordination, loss of inhibition, euphoria, and mild impairment of judgment
- Know alcohol withdrawal. When are the symptoms going to manifest? Know the symptoms
Early can manifest as early as 6-12hours after the last drink, major withdrawal 2-3 days. Irritability, agitation, anxiety
- Know legal intoxication and toxicity. In ATI book on pg 94
80% blood test and 0.08% breathalyzer
- Know health complications related to alcoholism. Pg1111
Cirrhosis (liver damage), cardiomyopathy, gastrointestinal bleeding, pancreatitis, hypertension, stroke, sleep disturbances, malnutrition, peripheral neuropathies, cognitive impairment, leukopenia (decrease white blood cells), and chronic infection.
- Know diagnosing an alcohol dependency problem. pg1111
Withdrawal, significant impairment in family relationships, impact on occupational productivity, presence of blackouts, drinking despite serious personal and professional consequences, and evidence of tolerance
- Know how to treat substance abuse people.
Symptomatically, give them fluids, benzodiazepines.
Phenytoin
Dilantin
Promethazine
Phenergan
Dicyclomine
Bentyl
Disulfiram
Antabuse
- Vivitrol, what do we use this for? Nursing implications
Alcohol rehabilitation, advise patients about side effects such as dizziness, fatigue, headache, nausea, nervousness, sleeplessness, and vomiting. Screen for history of liver problems. Is non addictive, once-monthly injection. Caution that concurrent use of heroin can cause withdrawal symptoms or even death.
Suboxone
buprenorphine
Narcan
naloxone
Zyban
Bupropion
Chantix
varenicline
- Know what’s in a banana bag?
Normal saline, magnesium sulfate, folic acid, multivitamins, thymine
- Know what will happen to me if I take Antabuse and I am exposed to alcohol.
You will throw up, have chills, have muscle cramps, and get really sick
- Know the benefits of group therapy pg1113
Helps break through denial and gives the patient a new sense of belonging and identity
- Methadone and Suboxone are used for?
Used as a heroin substitute in rehabilitation programs
- Know Suboxone administration
Place the film or tablet under the tongue and let dissolve
- Know Narcan administration
Nasal spray, one nostril, may have to administer multiple times or put the patient on a narcan drip
advise patients that drugs may cause insomnia; do not take them at bedtime. Do not chew, divide, or crush tablets. Treatment usually lasts 7 to 12 weeks. May not notice therapeutic effects for 1 week. Instruct to avoid alcohol while taking this drug
Zyban
teach patients to begin taking 1 week before the stop date. Side effects include nausea or decreased appetite, headaches, insomnia, or vivid dreams. Use cautiously in renal impairment. May cause suicidal tendency; report suicidal thoughts to health care provider immediately
Chantix
- Know the acronym FRAMES pg1113
Feedback about personal status, responsibility to change, advice for change, menu for options, empathy in counseling, and self-efficacy for changes
is a life-threatening yet reversible medical emergency that arises from thiamine deficiency, with symptoms that include confusion, gait ataxia, and abnormal involuntary eye movements
Wernicke
is a chronic, irreversible, memory disorder that arises after a severe lack of thiamine
Korsakoff syndrome
- Know the first step of AA box48.2
We admitted we were powerless over alcohol that our lives had become unmanageable
- Know what a brain scan of a patient with Korsakoff pg1114
A brain scan will show brain atrophy; currently there is no treatment to totally reverse this condition, but long term administration of thiamine, other vitamins, and, magnesium may improve systems
- Know about support groups
The purpose of support groups is to help promote healthy relationships, learn and practice new coping skills, and reduce stress and anxiety. SUpport groups borrow from the principles of group therapy. Universality, cohesiveness, catharsis, altruism, information giving, improved social skills, and intrapersonal learning
The greatest danger for overdose of opiates is
respiratory depression
- Know slang names for Methamphetamines and Cocaine
Cocaine is known as coke, snow,, blow, and nose candy, meth is known as speed, crank, crystal, ice
- Know the health conditions related to nicotine abuse. Pg1117
Heart disease, stroke, many cancers, hypertension, premature wrinkling of the skin, bad breath, and discoloration of the fingernails
- Know about the cultural considerations related to cigarettes pg 1117
In 1966 the US surgeon general’s health warnings were placed on all cigarette packages. Since then, similar warnings have been put on other tobacco products. Television and radio advertising for cigarettes was banned in 1971. Education and an increase in cigarette taxes ,along with restrictions on smoking in public places, have also contributes to the decrease
- Commonly called gateway drug?
Marijuana
- Know about withdrawal from Marijuana
There is no withdrawal syndrome for cannabis
- Hallucinogens and Inhalants, the two most common ones.
Diethylamide (LSD) and phencyclidine hydrochloride (PCP or angel dust)
- Know what the biggest problem is for hallucinogens and inhalants.
Use is known to cause panic, paranoia, and death from extremely imaired judgment
- Know commonly abused inhalants
Glue, nail polish remover, aerosol packaged products, paint thinner, and other types of solvents
- Symptoms of use and the treatment for hallucinogens and inhalants
Acute confusion, excitability, hallucinations. Provision of safety for the individual who may be experiencing a bad trip. Emergency measures may be necessary to provide respiratory support for an individual who has impaired gas exchange as a results of inhalants
- CAGE questionnaire
A quick and simple assessment tool for alcohol abuse is the CAGE questionnaire, which includes four questions regarding the patient’s feelings about their drinking and specific habits. A “yes” answer to two or more of the four questions has a 90% correlation with alcohol abuse
- Know the cultures who have a higher incidence disorder pg93 in ATI book
Alaska natives and native american groups
- What is the “date-rape drug”?
Rohypnol
