Exam 4: Substance Abuse, Community, PTSD, ETC

Question 1

What are the 8 Therapeutic Communication Techniques

Answer 1

Offering Self
Giving Broad Options
Active Listening
Seeking Clarification 
Placing the Event in Time or Sequence
Making Observations
Voicing Doubt
Offering Hope and Humor

Question 2

What routes can lorazepam be given?

Answer 2

PO, IM, IV

Question 3

What is Lorazepam commonly prescribed for?

Answer 3

Anxiety, Epilepsy, Insomnia

Question 4

What is PTSD Defined as

Answer 4

Post Traumatic Stress Disorder: mental health condition that develops following a traumatic event

Question 5

What are the signs and symptoms of PTSD?

Answer 5

Reliving: Flashbacks, hallucinations, nightmares of the trauma
Avoiding: avoiding people, places, things or memories that remind them of the trauma
Excessive arousal, increased alertness, anger, fits of rage, irritability or hatred, difficulty sleeping and concentrating
Negative thoughts or feelings such as guilt
Flat affect(emotional numbness)

Question 6

What does acute, chronic and delayed mean in terms of PTSD symptom apperance?

Answer 6

Acute is under three months
chronic is over three months
delayed is 6 months or longer can be up to years

Question 7

Nursing interventions for a pt with PTSD

Answer 7

monitor suicidal thoughts
encourage expression of feelings
provide calm environment
assure safety/ help to develop a safety plan
administer medications
monitor medication effects
teach relaxation, supporting stress reduction
monitor mental status and behaviors

Question 8

Nursing interventions for a pt on lorazepam

Answer 8

monitor vital signs and respirations to establish a baseline
ensure call bell is within reach, and they have a clear safe path to the bathroom
educate on not mixing alcohol with medication
caution them on participating in activities like driving or making serious decisions until they are aware of how they are affected by the medications
check their liver and kidney functions and monitor levels.

Question 9

what is addiction

Answer 9

repeated compulsive use of a sub stance that continues despite negative consequences

Question 10

what is withdrawal

Answer 10

the physiological response to the abrupt stopping or reduction in a substance used usually for a long time

Question 11

what is tolerance

Answer 11

increasing amounts of a substance are needed over time to achieve the same effect than previously obtained with smaller amounts

Question 12

what is substance dependence

Answer 12

a condition which a person has had several usually three of the following symptoms for one month or longer

Question 13

what is denial

Answer 13

common ego defense mechanism used by people who are substance abusers

Question 14

what are the two phases of alcohol treatment for patients

Answer 14

1st phase focuses on detoxification

2nd phase focuses on treatment

Question 15

What are options for alcohol withdrawal treatment

Answer 15

antabuse or revia or campral (medication)

group therapy

Question 16

What are red flags for an impaired nurse?

Answer 16

documenting the administration of more as needed medications than other nurses
the nurse administers medication for another nurses patient.
forgets to obtain a witness to discard a controlled substance
signs out a larger dose of controlled substance when the ordered dose is available, then signs it as discarded or wasted
signs out the dose but isn’t documented in the MAR or in their notes
says a controlled substances access code was shared with another nurse
withdrawal times don’t correspond with administration times
inaccuracies in the narc count when a particular nurse works
staff signatures or initials appear to be forged
times and amounts of signed out narcs aren’t authorized by the health providers orders
controlled substances are signed out for a patient who has no order for them
the patient isn’t on the clinical unit at the time the dose is documented
the patients report that the pain medication doesn’t relieve their pain on the nurses shift

Question 17

What do you do following the ANA framework for when impairment is suspected

Answer 17

privately speak to the suspected nurse about your concerns
remind him or her about available employee assistance programs, be prepared that the nurse many not be receptive to seeking treatment, denial shouldn’t prevent you from escalating your concerns
have a discussion with your manager about your concerns and provide objective rationales to substantiate your claims

Question 18

What are some other signs of impairment

Answer 18

glassy eyes or pupil changes
slurred speech
drowsiness
tremors
unsteady gait
sweating
frequent runny nose
frequent nausea, vomiting or diarrhea
noticeable change in weight
alterations in eating and bathroom habits
changes in personal grooming
forgetfulness
poor judgement or mistakes
difficulty completing responsibilities
arrives late or leaves early
inappropriate behavior or outbursts
need for increased breaks from work area
lying about behaviors
hyperactivity or hypoactivity
inappropriate attire for environment, long sleeves in warm weather

Question 19

What is the funding for the Red Cross

Answer 19

Donations, blood, monetary and inkind

Question 20

services the red cross offers

Answer 20

blood donation, CPR, first aid and lifeguard training, Disaster relief, humanitarian aid, military family services

Question 21

how is WIC funded

Answer 21

by congressional appropriations to states, territories and tribal organizations

Question 22

When was the salvation army established

Answer 22

1865

Question 23

What services does the salvation army offer

Answer 23

food bank, monetary assistance with utilities, services for aging