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Mental Health 2024 - JF > Chapter 14 - Substance Abuse - Exam 3 > Flashcards

Chapter 14 - Substance Abuse - Exam 3 Flashcards

1
Q

what is the difference between substance use disorder and substance induced disorder?

A

substance use disorder = addiction
substance induced disorder = byproducts of addiction

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2
Q

what does an opiate withdrawal timeline look like?

  1. 72 hours after last dose
  2. 1 week after last dose
  3. 2 weeks after last dose
  4. 1 month after last dose
A
  1. physical symptoms at their peak: chills, fever, body aches, diarrhea, insomnia, muscle pain, nausea, dilated pupils
  2. physical symptoms start to lessen: tiredness, sweating, body aches, anxiety, irrtability, nausea
  3. psychological and emotional symptoms: depression, anxiety, irritability, restlessness, trouble sleeping
  4. cravings and depression; symptoms can linger for weeks or months
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3
Q

what is a psychoactive substance

A

substances that, when taken in or administered into one’s system, affect mental processes, e.g. perception, consciousness, cognition or mood and emotions.

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4
Q

A child of an alcoholic is ____ times as likely to become an alcoholic

A

4

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5
Q

which addiction is linked to genetics

A

alcoholism

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6
Q

Alcohol use disorder:
Explain phase 1 - prealcoholic phase

A

a person might have one or drink after a long day at work in an effort to reduce tension, stress, and to relax

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7
Q

Explain phase 2 - early alcoholic phase

A

person starts to drink more, brief periods of amnesia/blackouts, alcohol stops being a source of please and more of a need, this person can get defensive if confronted with drinking use

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8
Q

Explain phase 3 - the crucial phase

A

this person has lost the ability to choose to drink and it is “required” i.e. they “have to have it.” This person is angry/aggressive, they may have lost their job, they may feel a sense of shame

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9
Q

Explain phase 4 - the chronic phase

A

this person is drunk more than they are sober; they have an emotional and physical dependence on alcohol. At this stage, withdrawal needs to be managed carefully

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10
Q

which of the following are substance-induced disorders?

-intoxication
-withdrawal
-delirium
-neurocognitive disorder
-psychosis
-bipolar
-depressive disorder
- ocd
-anxiety
-sexual dysfunction
-sleep disorders

A

all of them

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11
Q

addiction: a compulsive or chronic requirement. the need is so strong as to generate distress (either physical or ______) if left unfulfilled

A

psychological

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12
Q

individuals are considered to have a _________disorder when use of the substance interferes with their ability to fulfill role obligations (work, school, home)

A

substance

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13
Q

true or false
individuals with substance use disorders often participate in dangerous activities when they are impaired by a substance

A

true

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14
Q

true of false
once individuals realize they have a problem it is easy for them distoninue use since they know that it is contributing to a physical or psychological problem

A

false

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15
Q

substance intoxication is defined as the development of a _________ syndrome of symptoms following excessive use of a substance

A

reversible

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16
Q

once intoxicated there is a direct effect on the _____ and a disruption in physical and psychological functioning occurs

A

cns

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17
Q

true or false
caffeine is considered a psychoactive substance that is associated with substance use

A

true,
along with all the classic ones, plus tobacco

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18
Q

hereditary factors appear to be involved in the development of substance use disorders, especially ____

A

alcoholisim

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19
Q

true or false
children of alcoholics are 4 times more likely than other children to become alcoholics

A

true

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20
Q

although there is no single factor that determines whether someone will develop a substance use disorder, it is estimated that _______ accounts for 40 to 60 percent of a person’s vulnerability

A

genetics

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21
Q

there is good evidence that changes in brain structure and brain neurochemistry occur in the process of addiction.
Alcohol has demonstrated effects on almost all neurotransmitters, but those most strongly linked to sub abuse include

A

opioid, dopamine, glutamate, and gaba

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22
Q

once activated, neuronal pathways that are responsible for sensing pleasure and reward are believed to be responsible for pleasurable sensations associated with addictive substances as well as creating a memory that triggers a desire for repeated use

these pathways are referred to as

A

the brain-reward circuitry

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23
Q

certain personality traits have been associated with an increased tendency towards addiction.

can you name a few?

A

low self esteem, depression, passivity, antisocial, high risk taking, trouble communicating, anxiety

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24
Q

irrational thinking patterns have long been identified as a problem that is central in addiction
some example of irrational thinking patterns associated with addiciton include…

A

denial “im not addicted!”
projection “its my wifes fault i take drugs!”
rationalization “i have to take the drugs im in pain”

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25
Q

Exploring irrational thought patterns is the basis for ________ therapy and has shown benefits in addiction treatment

A

CBT

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26
Q

__________ is a learned response that occurs after repeated exposure to a stimulus

A

conditioning

substance abuse can become a learned response from the substance, environment, etc

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27
Q

an abbreviation for alcohol often seen in medical records is

A

ETOH

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28
Q

alcohol is thought to have more profound effect when an individual is _________ stressed or fatigued

A

emotionally

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29
Q

most alcohol metabolized in the liver, the outcome of this process is the produciton of

A

acetaldehyde

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30
Q

increased exposure to acetaldeyde leads to CNS ______

A

depression

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31
Q

phase 1 the prealcoholic phase

this phase is characterized by the use of alcohol for its effects in relieving the everyday _____ and ______ of life
the individual may have at some point learned the use of alcohol is an acceptable method of coping with stress

A

stress and tension

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32
Q

phase 2: early alcoholic phase

this phase begins with ____.
now the alcohol is no longer a source of pleasure or relief for the individual but rather a drug that is _____ by the individual

A

blackouts, required

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33
Q

phase 3: crucial phase

now the individual has lost ______ and _______ addiction is clearly evident.
binge drinking is common - these episodes include sickness, loss of consciousness, squalor, degradation.

In this phase the individual is extremely ill. _____ has become the total focus, this person is willing to lose everything that was once important in order to maintain addiction

A

control, physiological,

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34
Q

Phase 4: chronic phase

this phase is characterized by emotional and physical disintegration. This person is usually ____ more than they are sober.
_______ disintegration is evidenced by profound helplessness and self pity
impairment in reality testing may result in _____

A

intoxicated, emotional, psychosis

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35
Q

phase 4: chronic phase

unmanaged withdrawal results in terrifying symptoms that include

A

hallucinations, tremors, convulsions, agitation, panic, depression, thoughts of suicide

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36
Q

alcohol is considered a food since it has calories, but unlike other food it does not have to be digested because…

A

the blood carries 20% of the alcohol directly to the brain where it acts on the brains central control areas, slowing or depressing activity

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37
Q

Effects on the body:

peripheral neuropathy is characterized by peripheral ______damage, this results in pain, burning, tingling/prickling sensations

A

nerve

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38
Q

peripheral neuropathy:

**remember this one!
researchers believe that peripheral neuropathy is a direct result of deficiencies in

A

the B vitamins - particularly THIAMINE

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39
Q

peripheral neuopathy:

this process is often reversible with abstinence, but with chronic alcohol use ________ wasting and ________ can occur

A

muscle, paralysis

40
Q

alcoholic myopathy:

this may be an acute or chronic condition, (aka alcoholic RHABDOMYOLYSIS <— remember this term it comes up a lot)

the man (Im just using man because its quicker to type obviously could be man or woman) experiences:

A

muscle pain, swelling, weakness,

41
Q

alcoholic myopathy:

the man may have myoglobinuria evidenced by

A

red tinge in urine

42
Q

alcoholic myopathy:

__________ may be elevated before the appearance of symptoms

A

creatine kinase

43
Q

alcoholic myopathy:

lab studies show elevations of the enzymes creatine phosphokinase (CPK), lactate dehydrogenase (LDH), aldolase, and aspartate aminotransferase (_____)

A

AST

44
Q

alcoholic myopathy:

again, the main point is that chronic alcoholic myopathy produces symptoms which are

A

gradual muscle wasting and weakness in skeletal muscles

45
Q

alcoholic myopathy:

alco myopathy is thought to be the result of the same _______ deficiency that contributes to peripheral neuropathy

A

vitamin B

46
Q

** important

wernicke’s encephalopathy represents the most serious form of ______ deficiency in alcoholics

A

thiamine

47
Q

wernicke’s encephalopathy:

symptoms include

A

paralysis of ocular muscles, diplopia, ataxia, somnolence, and stupor

48
Q

paralysis of OCULAR muscles, diplopia, ataxia, somnolence, and stupor are symptoms of what

A

wernicke’s encephalopathy

49
Q

Korsakoff’s psychosis is identified by the syndrome of

A

confusion, recent memory loss, and confabulation

50
Q

confusion, recent memory loss, and confabulation are symptoms of

A

korsakoff’s psychosis

51
Q

Korsakoff’s psychosis:

it is frequently encountered in clients recovering from

A

wernicke’s encephalopathy

52
Q

korsakoff’s psychosis:

treatment includes

A

parenteral or oral thiamine replacement

53
Q

why is thiamine so important?

A

Thiamine, also known as Vitamin B1, is an essential nutrient that plays a crucial role in maintaining proper function of the nervous system, muscles, and heart. Here are some key functions of thiamine:

Energy Metabolism: Thiamine is a coenzyme in important metabolic pathways, particularly in the breakdown of carbohydrates, such as glucose, to produce energy. It helps convert food into energy that the body can use.

Nervous System Function: Thiamine is essential for the proper functioning of the nervous system. It is involved in the synthesis of neurotransmitters, which are chemicals that transmit signals in the brain and nervous system. Thiamine deficiency can lead to neurological symptoms such as confusion, memory problems, and muscle weakness.

Heart Health: Thiamine is important for the proper functioning of the heart muscle. It helps maintain the integrity of the cardiovascular system and supports normal heart function.

Gastrointestinal Function: Thiamine plays a role in the digestion of carbohydrates in the gastrointestinal tract. It helps in the production of hydrochloric acid, which is necessary for the digestion of food.

Healthy Growth and Development: Thiamine is important for normal growth and development, particularly during periods of rapid growth such as infancy, childhood, and pregnancy.

Overall, thiamine is essential for maintaining overall health and well-being, and a deficiency can lead to a variety of health problems, including beriberi and Wernicke-Korsakoff syndrome. It’s found naturally in many foods, including whole grains, legumes, nuts, seeds, and pork, among others.

54
Q

alcoholic cardiomyopathy:

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

A

lipids

55
Q

alcoholic cardiomyopathy:

symptoms include:

A

exercise intolerance, tachycardia, dyspnea, edema, palpitations, nonproductive cough

56
Q

alcoholic cardiomyopathy:

lab studies may show and elevation in enzymes

A

CPK, AST, ALT, LDH

57
Q

true or false

alcoholic cardiomyopathy results in the heart shrinking

A

false, the enlargement of the heart

58
Q

what the hell is esophagitis

A

inflammation and pain in the esophagus, this occurs due to the toxic effects of alco on the mucosa

59
Q

Gastritis:

how does alcohol affect our stomachs?

A

inflammation of lining, nausea, vomiting, distension

60
Q

gastritis:

alcohol breaks down the stomach’s protective mucosal barrier, allowing _______to erode the stomach wall

A

hydrochloric acid

61
Q

pancreatitis:

usually occurs 1 to 2 days after a binge. Symptoms include constant, severe epigastric pain, N/V, and abdominal distention.

chronic pancreatitis leads to

A

pancreatic insufficency leading to steatorrhea, malnutrition, weight loss, and diabetes mell

62
Q

alcoholic hepatitis is _________ of the liver caused by long term heavy alcohol use

A

inflammation

63
Q

alcoholic hepatitis:

clinical s/s include: N/V, lethargy, anorexia, elevated WBC, fever, jaundice, and most notably

A

an enlarged and tender liver

64
Q

Severe alco hepatitis can lead to cirrohis or

A

hepatic encephalopathy

65
Q

cirrhosis of the liver:

may be caused by anything that results in chronic injury to the liver.
it is the ____stage of alco liver disease and results from long term abuse

A

end

66
Q

Cirrhosis of the liver patho

A

widespread destruction of liver cells, which are replaced by fibrous (scar) tissue

67
Q

cirrohsis of the liver:

clinical manifestations include: N/V, anorexia, weight loss, ab pain, edema, anemia, blood coagulation abnormalities, and most notably

A

jaundice

68
Q

Complications of cirrhosis of the liver include:
- portal hypertension
- ascites
- esophageal varies
- hepatic encephalopathy

tell me the main points of these conditions

A
  • portal hypertension: elevation of bp thru the portal circulation results from defective blood flow
  • ascites: excessive serous fluid accumulates in th abdomen, occurs in response to portal hypertension

-esophageal varices: distended veins in esophagus from excessive pressure of defective blood flow thru the cirrhotic liver. **varies can rupture resulting in dangerous hemorrhaging

  • hepatic encephlopathy: *** serious complication in response to the inability of the dis liver to convert ammonia to urea for excretion –> leads to impaired mental functioning
69
Q

complications of cirrhosis:

elevation of bp thru the portal circulation results from defective blood flow thru the cirrotic liver is called

A

portal HTN

70
Q

complications of cirrhosis:

a condition in which an excessive amount of serous fluid accumulates in the abdominal cavity, occurs in response to portal HTN.
the increased pressure results in the seepage of fluid from the surface of the liver into the abdominal cavity

A

ascites

71
Q

complications of cirrohosis:

veins in the esophagus that become distended because of excessive pressure from defective blood flow thru cirrohitc liver.
as pressure increases variscosities can rupture

A

esphageal varices

72
Q

complications of cirrhosis:

this serious complication occurs in response to the inability of the dis liver to convert ammonia to urea for excreation.

the continued rise of ammonia results in progressively impaired mental functioning, apathy, euphoria, depression, CONFUSION, coma, death

A

hepatic encephalopathy

73
Q

leukopenia

A

production, function, and movement of WBCs are impaired —> infections

74
Q

thrombocytopenia

A

platelet production and survival are impaired -> hemorrhage

75
Q

fetal alcohol syndrome includes mental, physical, behavioral and/or learning disabilities
There may be problems with:

A

learning, memory, attention span, communication, vision, hearing,

76
Q

true or false
every infant develops FAS whose mother drinks during pregnancy

A

false, not every child, several factors determine consequences of maternal drinking:
pattern, metabolisim, genetics, timing,

77
Q

neuroimaging of child with FAS shows that the _____ and _____ are often smaller than normal

A

frontal lobes, cerebellum

78
Q

intoxication usually occurs at blood alcohol levels between 100 to ____ mg/dL

A

200

79
Q

alcohol withdrawal:

4 to 12 hours after a binge the following w/d symptoms may appear:

A

tremors, N/V, malaise, weakness, tachycardia, sweating, increased bp, anxiety, depression
irritability, hallucinations, illusions,

80
Q

ugh okay i didnt realize how long this chapter is so moving on to main points of sedative, hypnotic, or anxiolytic use disorder:

these types of substances in relation to addiction are divided into 3 categories what are they

A

barbiturates, nonbarbiturates, and antianxiety agents

81
Q

effects on body

A

general depressant effect

82
Q

okay sorry i cant read all this, im skipping ahead to nursing assessment stuff:

motivational interviewing is an approach that can be used with any disorder. Its focus is on using skills such as empathy and reflection to explore a client’s motivation, strengths, and readiness for change

through this process the client becomes _____to become an active partner in treatment goals while exploring feelings for any resistance to change

A

empowered

83
Q

motivational interviewing:

for example, rather than telling a client he must abstain from alcohol and attended AA, the health care provider helps the client ______ what he wants to achieve and then facilitates the process of exploring advan and disadvan of desired behavior change

A

articulate

84
Q

motivational interviewing:

what are some questions we could ask that client that have this approach of exploring the clients attitudes and feelings toward their addiction

A

are you comfortable with your drinking patterns?
have your attitudes towards drinking changed?
do you see alcohol abuse as a sign of weakness?
what did you learn from your parent about drinking?

85
Q

nursing assessment:

one of the most popular screening tools is

A

CIWA, (the clinical institute withdrawal assessment of alcohol scale)

86
Q

what does CIWA assess

A

monitoring of alcohol withdrawal symptoms

87
Q

what are some nursing diagnosis we could use for the patient with sub abuse

A

denial
ineffective coping
imbalanced nutrition
risk for infection
chronic low self esteem
deficient knowledge
risk for injury
risk for suicide

88
Q

what outcomes could we use for this patient

A

no physical injury
has not harmed self or others
accepts responsibility
acknowledges association between personal problems and use of substance
adaptive coping mech
no signs of infect
evidence of increased self worth
verbalizes importance of abstaining

89
Q

codependency is able to achieve a sense of _____ only thru fulfilling the needs of others

A

control

90
Q

the codependent person disowns his own needs and wants in order to respond to external _____ of others

A

demands

91
Q

codependence has been referred to as “a dysfunctional realtionship with ______”

A

oneself

92
Q

treating codependency:

explain the main points of these stages

stage 1 - the survival stage
stage 2 - the reidentification stage
stage 3 - the core issues stage
stage 4 - the reintegration stage

A
  1. let go of denial that problems exist
  2. individual gains glimpse of true self thru a break in denial
  3. individual must face that relationships cannot be managed by force of will
  4. self-acceptance and willingness to change - relinquish power over others and reclaim personal power
93
Q

pharmacotherapy:

what is disulfiram?

A

drug that can be used as a deterrent to drinking - drinking causes uncomfortable symptoms

94
Q

pharmacotherapy:

________ are the most widely used group of drugs for treatment in alcohol withdrawal

A

benzodiazepines (ativan, valium)

95
Q
A

Mental Health 2024 - JF (11 decks)

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