chp 24: meds for substance use disorders

Question 0

***alcohol withdrawal symptoms

Answer 0

n/v, tremors, restlessness, insomnia

depressed tonic clonic seizure and illusions

Question 1

***alcohol withdrawal

Answer 1

symptoms start w/in 4-12hrs of the last intake of alcohol
peak after 24-48hrs then suddenly disappear
delirium may occur 2-3days after cessation of alcohol

Question 2

***alcohol withdrawal delirium

Answer 2

may occur 2-3days after cessation of alcohol and may last 2-3days
considered a medical emergency

Question 3

***alcohol withdrawal delirium manifestations

Answer 3

severe disorientation
psychotic effects (hallucinations)
severe hypertension
cardiac dysrhythmias
delirium

Question 4

***meds to support withdrawal/ abstinence from alcohol

Answer 4

benzodiazepines
tegretol
catapres
inderal

Question 5

benzodiazepines to support withdrawal/abstinence from alcohol

Answer 5

librium
valium
ativan
serax

Question 6

***intended effects of benzodiazepines for treatment of alcohol withdrawal

Answer 6

maintenance of the client’s vitals within normal
decrease risk of seizures
decreases in the intensity of withdrawal manifestations

Question 7

***nursing intervention for benzodiazepines for alcohol withdrawal

Answer 7

obtain baseline vitals
monitor clients neurological status
provide for seizure precaustions

Question 8

adjunct meds intended effects for alcohol withdrawal

Answer 8

decrease seizures
	carbamazepine
depression of autonomic response
	decrease BP and HR
decrease craving
	propanolol

Question 9

nursing interventions for adjunct meds for alcohol withdrawal

Answer 9

provide for seizure precautions

obtain the pt’s baseline vitals

Question 10

meds for abstinence maintenance (following detox)

alcohol

Answer 10

antabuse
vivtrol
campral

Question 11

disfiram (antabuse) intended effects

Answer 11

it is a daily oral med that is a type of aversion (behavioral) therapy
used concurrently w/ alcohol will cause acetaldehyde syndrome to occur
acetaldehyde syndrome can lead to resp depression, cardio suppression, seizures and death

Question 12

disulfiram (antabuse) nursing interventions

Answer 12

inform the pt of the potential dangers of drinking alcohol
advise pt that med effects such as the potential for acetaldehyde syndrome with alcohol ingestion, persist for 2weeks following discontinuation
monitor liver function tests

Question 13

naltrexone (vivtrol) intended effects

Answer 13

pure opioid antagonist that suppresses the craving and pleasurable effects of alcohol
:also used for opioid withdrawal

Question 14

nursing interventions ( naltrexone) vivtrol

Answer 14

assess client’s hx of opioid dependency
increases pts risk of overdose with opioids
take with meals to decrease GI upset
monthly IM injections for clients who have difficulty adhering to med regimen

Question 15

acamprosate (campral) intended effects

Answer 15

taken orally three times a day to reduce the craving for alcohol

Question 16

nursing interventions acamprosate (campral)

Answer 16

diarrhea may result
maintain hydration
avoid use in pregnancy

Question 17

meds to support withdrawal from opioids

Answer 17

methadone
clonidine (catapres)
buprenophine (subutex)

Question 18

methadone intended effects

Answer 18

opioid agonist
replaces opioid which client is addicted to
prevents abstinence syndrome and removes the need for the client obtain illegal opioids
used for withdrawal and long-term maintenance
dependence is transferred from illegal opioid to methadone

Question 19

methadone nursing intervention

Answer 19

med must be administered from an approved treatment center

Question 20

intended effects of clonidine

Answer 20

assists with withdrawal effects r/t autonomic hyperactivity
diarrhea, N/V
doesnt reduce the craving for opioids

Question 21

nursing interventions for clonidine

Answer 21

baseline vitals
advise client to avoid activities that require mental alertness until
drowsiness subsides
chew sugarless gum or suck on hard candy

Question 22

buprenophine (subutex) intended effects

Answer 22

agonist antagonist opioid used for detox and maintenance
decreases feelings of craving
effective in maintaining compliance

Question 23

nursing interventions buprenorphine (subutex)

Answer 23

med must be administered from approved treatment center

admin med sublingually

Question 24

a nurse is providing teaching to a client who has a new prescription for tegretol. which of the following should the nurse include in teaching

Answer 24

this med will help prevent seizures during alcohol withdrawal

Question 25

a nurse is assisting in the discharge planning for a client following alcohol detox. the nurse should anticipate prescriptions for which meds to promote long-term abstinence from alcohol

Answer 25

disulfiram (antabuse)
naltrexone (vivitrol)
acamprosate (campral)

Question 26

a nurse is evaluating a client’s understanding of a new prescription of clonidine (catapres). which of the following statements by the client indicates an understanding of the teaching

Answer 26

while taking this med i should keep a pack of sugarless gum

Question 27

a nurse is teaching a client who has tobacco use disorder about the use of nicotine gum. which of the following is appropriate to include in the teaching

Answer 27

avoid eating 15min prior to chewing the gum

Question 28

a nurse is discussing the use of methadone with a newly licensed nurse. which of the following statements by the newly licensed nurse indicates a need for further teaching

Answer 28

methadone increases the client’s risk for acetaldehyde syndrome
***disulfiram does this not methadone

• **methadone is a replacement for the client’s opioid addiction
• **it reduces the unpleasant effects assoc. w/ abstinence syndrome
• **it can be used during opioid withdrawal and to maintain abstinence