Exam 4: Substance Abuse, Community, PTSD, ETC Flashcards
What are the 8 Therapeutic Communication Techniques
Offering Self Giving Broad Options Active Listening Seeking Clarification Placing the Event in Time or Sequence Making Observations Voicing Doubt Offering Hope and Humor
What routes can lorazepam be given?
PO, IM, IV
What is Lorazepam commonly prescribed for?
Anxiety, Epilepsy, Insomnia
What is PTSD Defined as
Post Traumatic Stress Disorder: mental health condition that develops following a traumatic event
What are the signs and symptoms of PTSD?
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)
What does acute, chronic and delayed mean in terms of PTSD symptom apperance?
Acute is under three months
chronic is over three months
delayed is 6 months or longer can be up to years
Nursing interventions for a pt with PTSD
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
Nursing interventions for a pt on lorazepam
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.
what is addiction
repeated compulsive use of a sub stance that continues despite negative consequences
what is withdrawal
the physiological response to the abrupt stopping or reduction in a substance used usually for a long time
what is tolerance
increasing amounts of a substance are needed over time to achieve the same effect than previously obtained with smaller amounts
what is substance dependence
a condition which a person has had several usually three of the following symptoms for one month or longer
what is denial
common ego defense mechanism used by people who are substance abusers
what are the two phases of alcohol treatment for patients
1st phase focuses on detoxification
2nd phase focuses on treatment
What are options for alcohol withdrawal treatment
antabuse or revia or campral (medication)
group therapy
What are red flags for an impaired nurse?
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
What do you do following the ANA framework for when impairment is suspected
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
What are some other signs of impairment
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
What is the funding for the Red Cross
Donations, blood, monetary and inkind
services the red cross offers
blood donation, CPR, first aid and lifeguard training, Disaster relief, humanitarian aid, military family services
how is WIC funded
by congressional appropriations to states, territories and tribal organizations
When was the salvation army established
1865
What services does the salvation army offer
food bank, monetary assistance with utilities, services for aging
