Chapter 22 Part 4 Flashcards
Nonjudgmental attitude
Maintain an open and accepting demeanor.
Patient reassurance
Confirm condition is drug-related, temporary.
Verbalization assistance
Help patient express their experiences.
Event timeline
Outline expected sequence of occurrences.
Concrete statements
Use clear, simple language for communication.
Orientation
Help patient recognize time, place, and people.
Self-identification process
Assist patient in recognizing familiar objects.
Forewarning about drug effects
Prepare patient for changing mental states.
Talk-down technique
Avoid using with PCP-affected patients.
Substance abuse emergencies
Result from recent or cumulative substance use.
Alcohol abuse treatment
Address acute intoxication and related conditions.
Drug withdrawal
Symptoms occur when drug use is reduced.
Drug tolerance
Increased doses needed for same effects.
Psychological dependence
Compulsive behavior focused on drug acquisition.
Physical dependence
Physiological changes require drug to avoid withdrawal.
Commonly addictive drugs
Include narcotics, alcohol, sedatives, cocaine.
Withdrawal symptoms onset
Begins when next dose is due.
Withdrawal symptoms peak
Usually peaks 24-48 hours after cessation.
Signs of withdrawal
Include anxiety, agitation, confusion, tremors.
Alcohol use disorder
Characterized by problem drinking and addiction.
Signs of intoxication
Odor of alcohol on the breath.
Caution with alcohol breath
May indicate other medical conditions.
Seizure risk in withdrawal
Withdrawal can lead to seizures and complications.
Swaying and unsteadiness
Loss of balance often seen in intoxication.
Slurred speech
Impaired verbal communication due to alcohol effects.
Nausea and vomiting
Common physical reactions to excessive alcohol consumption.
Flushed face
Redness of the face indicating possible intoxication.
Drowsiness
State of reduced alertness often caused by alcohol.
Erratic behavior
Unpredictable actions often linked to intoxication.
Self-injury
Harmful actions towards oneself, often unrecognized.
Alcohol as a depressant
Substance that slows down brain function and reaction.
Respiratory center paralysis
Severe alcohol overdose can stop breathing.
Vital signs monitoring
Constant assessment of patient’s health indicators.
Aspiration prevention
Positioning to avoid inhaling vomit during unconsciousness.
Alcoholism forms
Includes beer, wine, hard liquor, and other substances.
Sedative dependency
Common co-occurrence of alcohol and sedative abuse.
Withdrawal symptoms
Physical reactions after stopping alcohol intake.
Delirium tremens (DTs)
Severe alcohol withdrawal syndrome with confusion and tremors.
Blackout periods
Loss of memory during excessive drinking episodes.
Wernicke-Korsakoff syndrome
Brain disorder from alcohol toxicity and malnutrition.
Chronic gastric ulcer
Long-term stomach sores often related to alcohol.
Upper gastrointestinal hemorrhage
Severe bleeding in the esophagus due to varices.
Hypoglycemia
Low blood sugar levels, common in alcoholics.
Subdural hematoma
Blood accumulation between the brain and its outer covering.
Withdrawal syndrome
Symptoms occurring after reducing alcohol intake.
Cirrhosis of the liver
Severe liver scarring from long-term alcohol abuse.
Cardiomyopathy
Heart muscle disease linked to chronic alcohol consumption.
Alcohol Withdrawal Syndrome
Symptoms from abrupt cessation of alcohol use.
Dose-Dependent
Severity increases with higher alcohol consumption.
Delirium Tremens
Severe, life-threatening alcohol withdrawal stage.
Alcoholic Tremulousness
Stage 1 symptoms include tremors and insomnia.
Alcoholic Hallucinosis
Stage 2 characterized by visual and auditory hallucinations.
Withdrawal Seizures
Stage 3 seizures with alternating muscle rigidity.
Stage 1 Symptoms
Nausea, insomnia, sweating, and tremors.
Stage 2 Symptoms
Worsening symptoms with added hallucinations.
Stage 3 Symptoms
Major seizures occurring after last drink.
Stage 4 Symptoms
Delirium tremens with confusion and hyperirritability.
Mortality Rate of DTs
Approximately 15-20% if untreated.
Onset of DTs
Occurs 48-72 hours after last drink.
Duration of DTs
Lasts 1-5 days, can recur.
Signs of DTs
Severe confusion, tremors, and hallucinations.
Common Symptoms of Withdrawal
Insomnia, nausea, sweating, and hypertension.
Hyperthermia
Elevated body temperature during withdrawal.
Tachycardia
Rapid heartbeat often seen in withdrawal.
Opioids
Agents mimicking morphine effects, natural or synthetic.
Opiate
Natural agents derived from opium.
Narcotic
Broad term for agents inducing sleep.
Heroin
Naturally occurring opiate acting on opiate receptors.
CDC Overdose Data
Estimated overdose deaths increased significantly in 2021.
Opioid Overdose Deaths
Estimated 75,673 deaths in 12 months ending April 2021.
Increase in Opioid Deaths
Overdose deaths rose by 15% from previous year.
Synthetic Opioids
Man-made drugs mimicking natural opioids’ effects.
Fentanyl
Synthetic opioid, 50-100 times stronger than morphine.
Methamphetamine
Psychostimulant linked to increased overdose deaths.
Tramadol
Another commonly abused synthetic opioid.
Nitazenes
New class of synthetic opioids identified in forensics.
Carfentanil
Opioid used as anesthetic for large animals.
CNS Depression
Reduced central nervous system activity and responsiveness.
Respiratory Depression
Decreased respiratory rate and tidal volume.
Miosis
Constricted pupils, common in opioid toxicity.
Seizures
Can occur due to hypoxia from respiratory depression.
Dysarthria
Speech disturbance from facial muscle paralysis.
Ataxia
Incoordination resulting from hypoxia and cell injury.
Tremors
Involuntary muscle contractions due to hypoxia.
Crackles
Sounds from pulmonary edema related to hypoxia.
Hearing Loss
Altered metabolism affecting ear function.
Hypotension
Low blood pressure due to CNS depression.
Bradycardia
Slow heart rate resulting from CNS effects.
Nausea
Vomiting due to decreased gastrointestinal motility.
Urinary Retention
Inability to urinate from urethral sphincter spasm.
Pruritus
Itching caused by histamine release.
Naloxone
Medication used to reverse opioid overdose effects.
Emergency Medical Care
Focus on reversing respiratory and CNS depression.
Opioid Poisoning
Severe reaction to opioid drugs requiring emergency care.
Naloxone
Opioid antagonist used to reverse overdose effects.
Patient Care Goals
Rapid recognition and prevention of respiratory arrest.
Inclusion Criteria
Decreased mental status and respiratory depression present.
Exclusion Criteria
Altered mental status from non-opioid causes.
PPE
Personal protective equipment to prevent exposure risks.
Therapeutic Interventions
Support airway, breathing, and circulation before naloxone.
Medication Identification
Determine specific opioid taken and time of ingestion.
Cardiovascular History
Document patient’s cardiovascular and medication history.
Needle Stick Risk
Increased risk of exposure to blood-borne pathogens.
Intravenous Route
Preferred for naloxone due to predictable bioavailability.
Intranasal Route
Alternative naloxone delivery method for opioid overdose.
Intramuscular Route
Another option for administering naloxone effectively.
Assessment Steps
Evaluate airway, breathing, circulation, and mental status.
Oxygen Administration
Provide supplemental oxygen to support respiratory function.
Transdermal Opioids
Opioids delivered via adhesive patches should be removed.
Critical Resuscitation
Immediate airway and circulation support before naloxone.
Respiratory Depression
Condition warranting naloxone administration in overdose cases.
Titration of Naloxone
Incremental dosing until respiratory function is restored.
Adult Naloxone Dose
Typical initial dose ranges between 0.4-2 mg.
Pediatric Naloxone Dose
Pediatric dose typically 0.1 mg/kg for overdose.
Maximum Naloxone Dose
Maximum adult dose is 10 mg IM or ETT.
ETT Route
Endotracheal route used in dire overdose situations.
ETT Route
Endotracheal tube route for naloxone administration.
Adult Dose
Typical initial dose for adults, IM or ETT.
Pediatric Dose
Naloxone dose for children, IM, IN, or ETT.
Maximum Dose
Highest allowable dose for IM or ETT use.
Naloxone Access
Provided to laypersons via public access programs.
Auto-Injector
Pre-measured naloxone dose in an auto-injector.