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chapter 25 Flashcards

Alcohol/substance dependence

1
Q

What does addiction mean ?

A

A condition of contained use of substance ( or reward-seeking behaviors ) despite adverse consequences

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2
Q

key terms we need to understand and define

use ?
abuse ?
withdrawal?
detoxification ?
relapse ?

A

ingestion, smoking, sniffing or injection of mind-altering substance

use for purpose of intoxication or beyond intended use

symptoms occurring when substance no longer used

process for safe withdrawal

recurrence

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3
Q

we usually like to diagnose patents with two types of categories what are they and explain to me what it means ?

A

substance use disorders
- you using the actual drug

substance induced disorder
- having a disorder that increases the chances of you behaving in those substances

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4
Q

how does abuse occur in a patient ?

A

when the purpose of intoxication or medical usage of the drug goes beyond the use

so like using weed to help aid pain, but now using weed to just get high and enjoy yourself

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5
Q

typically when dealing with patients with substance use, they usually present themselves with 3 coping mechanisms, which are and can you describe them to me?

A

denial
- I dont have a problem

projection
- you are the problem

rationalization
- im like this because of this non controllable factor

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6
Q

what is the most abused substance in the United States ?

A

alcohol

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7
Q

what is the patho behind how addiction comes to be ?

A

the increase in dopamine you get from the addiction that goes into your nucleus accumbens ( reward center )

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8
Q

more terms to understand?

tolerance
dependence
withdrawal
overdose
enabling

A

the more you need to feel a high

mental and physical need to do it to live

symptoms occurring when substance no longer used

toxic point of the consumption where life is on the line

enforcing and allowing the behavior

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9
Q

what type of approach should a nurse use when dealing with a patient in denial of their problem ?

A

noncontrontational approach

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10
Q

why do we want to use a noncontrtational approach with a patient with a substance abuse issue ?

A

dont blame them, you simply want to be kind and empathic

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11
Q

we also discussed about last time that the best way to interview a patient with substance abuse is ??

A

motivational interviewing

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12
Q

why is motivational interviewing beneficial to patients with substance abuse ?

A

helps the patient realize the discrepancy between life goals and engaging in substance use, it gives the patient the personal choice to treatment and changing behaviors

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13
Q

what race do we usually see alcohol abuse in the most ?

A

white

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14
Q

what is the primary treatment and recovery for patients with alcohol ?

A

recover, preventing relapse and working to safe detox

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15
Q

alcohol is known as a what ?

A

cns depressant

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16
Q

how does alcohol work as a cos depressant ?

A

it works by engaging in your gaba receptors to cause mild sedation and relaxation

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17
Q

in the online powerpoint used for alcohol, they want us to ask CAGE questionnaire questions, what does cage stand for ?

A

have you ever felt you should CUT DOWN on your drinking?

have people ANNOYED you by criticizing your drinking?

ever felt bad or GUILT about your drinking?

ever had an EYE OPENER to steady nerves in the morning?

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18
Q

what are some long term effects that patients can experience when using alcohol ?

A

usually develop a tolerance

need to drink increasing amounts before experiencing an high and show cognitive and motor effects

bals reflect increased

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19
Q

alcohol withdrawal and detoxification can present in many physiologic and psychological ways.

typically when do early signs of withdrawal symptoms occur ?

when do peak of withdrawal symptoms occur ?

A

4-12 hours

24-48 hours (2days)

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20
Q

typically patients who are going through a withdrawal or detox, symptoms rapidly disappear within the first 24-48 hours, however if they dont disappear and withdrawal progresses, what does it turn into ?

A

alcohol withdrawal delirium (awd) otherwise known as dt (delirium tremens )

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21
Q

typically how do patients who are experiencing alcohol withdrawal delirium or delirium tremens look like ? (7)

A

shaking
vomitting
increase pules
increase bp
increase temp
sweating

eventually can lead to a seizure

22
Q

AWD or delirium tremens is a medical emergency and why so?

A

the reason behind this is because patients will end up dying from the severe side effects and the brain will start to shut down typically seizure first

23
Q

what is the assessment or the tool we use to help ovulate a patient with alcohol usage?

A

ciwa
clinical institute withdrawal assessment

24
Q

what are 3 medications we are only going to be giving to these patients when they stop drinking alcohol to help prevent the consumption of it ?

A

naltrexone
acamprosate
disulfiram

25
naltrexone acamprosate disulfiram describe what each of them do and what we need to tell for one of them to avoid
blocks the high feeling of alcohol, reduces the appeal of alcohol reduce physical distress and emotional discomfort severe adverse reaction, and must instruct patient to avoid the use of any substance that contains alcohol, like cough medications, rubbing alcohol
26
what are the main medical concerns we have with patients who are consuming alcohol ? (4)
respiratory depression n/v tachycardia aspiration
27
how do patients who are intoxicated look like ? dont overthink it
slurred speech unsteady gait poor judgment loss of memory loss of inhibition increase aggression increase impulsiveness
28
patients, typically after many years of drinking, can develop wernickes-korsakoff syndrome, which is ?
a combination of encephalopathy and amnestic syndrome
29
what is wernickes encephalopathy what is the symptoms associated with it ?(5)
degenerative brain disorder caused by thiamine defiencency vision impairment ataxia hypotension confusion coma
30
what is Korsakoff amnestic syndrome ? what is the symptoms associated with it ? (5)
involves heart/vascular/ and nervous system but the pimrary problem is acquiring new information and retrieving memories amnesia confabulation attention deficit disorientation vision impairment
31
what are 3 medications we are going to prescribe to patients with alcohol issues to help aid in their recovery ?
benzodiapines thiamine zofran
32
why are we going to give benzodiapines , thiamine, zofran ?
benzo - help with that gaba receptor, by relaxing the patient thiamine - help prevent wenikes syndrome zofran - aid with the nausea that comes with withdrawals
33
* Prevention of Relapse * Psychosocial interventions * Medications: disulfiram, acamprosate calcium, naltrexone * Promotion of Health * Adequate nutrition and supplemental vitamins * Multivitamins essential due to malnutrition: thiamine, folic acid, magnesium sulfate
34
cocaine is often ingested as inhalant, injected or smoke what do you think the effects are on a person who does cocaine ?
sudden burst of mental alertness and energy
35
cocaine rush is that sudden burst of mental alertness that usually last for 10-20minutes, however its often followed by ?
depression, craving for more and irritability
36
how do patients who use cocaine/crack look like ? dont over think it
dilated pupils hallucination nose bleedings sniffing tachycardia
37
long term usage of cocaine has been found to effect your sleep, causing patients to sleep 12-18 hours. recovery is very difficult because of the intense craving that come with the withdrawal, so nursing interventions should focus on helping patients solve problems related to manage these cravings
38
nicotine is an uprising pandemic that has caught the nation by suprisied, its a stimulate that causes increase alertness, attention and suppresses your appetite. not only thing, mood swings and cravings are massive symptoms associated with nicotine its been used to help stop smoking but not a good way though
39
caffeine, increase mental acuity restless, gi disbutrances, tachy
40
cannabis and marijuana has been legalized in many states, and has helped with relaxation and medical usages of pain long term effects though can be lung irritating and addictive
41
hallucinogens and dissociative drugs causes what ?
euphoria, dysphoria, alerted body image, distorted or sharpened visual and auditory perception, confusion, incoordination and impaired judgment and memory
42
what is an example of hallucinogens ?
LSD
43
Currently believed that 15.2 million Americans use OTC medications for nonmedical purposes * Opioids: oxycodone, hydrocodone, morphine, fentanyl, codeine are the most commonly abused * Barbiturates and benzodiazepines * OTC cough medicines containing dextromethorphan (similar effects as with ketamine or PCP)
44
what is the most abused opioid ?
heroin
45
what happens when a patient overdose on opioids, what do we use ?
narcan
46
what are some symptoms of opioid withdrawal ? (6)
yawning runny nose fever n/v dysphoria insomnia
47
withdrawal peaks for patients for opioids when and when does it subside typically ?
2-3 days 5-7 days or longer
48
what is the treatment for opioids?
methadone Suboxone naltrexone
49
what do we use to test or evaluate a patient with an opioid addition ?
cows test
50
inhalants is a ______ causes what effects? risk for ?
cns depressant euphoria sudden sniffing death (cardiac arrest)
51
steroids cause euphoria effects and sexual arousal, however patients get the risk for heart attacks and blood clots men typically have women typically have
breast enlargement masculinization
52
gambling disorder is when it is persistent and recurrent, leading to clinically significant impairment and distress patient experience an aroused, euphoric state during the actual betting patients are unable to control their gambling and may lie to family, friends and employers to hide their gambling habit the disorder has 4 phases winning lossing desperation hopelessness

468 Psych exam 2 (9 decks)

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