mark k lecture 2 Flashcards
*How do you respond/treat to pts in denial?
Support = Loss
Confront = Abuse
Dependency
when they get the significant other to do things or make decisions for them
The abuser is dependent
Co-dependency
when the significant other derives self-esteem for doing things or making
decisions for the abuser
The significant other is the co-dependent
How do you treat dependency/codependency?
Dependent pts are “abusers” … Confront them
o Co-dependent pts have self-esteem issues … Teach pts how to set limits and enforce them
o Agree in advance on what requests are allowed then enforce
o Teach significant other to say no
o Work on self-esteem on the co-dependent person
Manipulation
Manipulation is when the abuser gets the significant other to do things or make decisions
that are not in the best interests of the significant other
o The nature of the act is dangerous and harmful to the significant other
Wernicke (Korsakoff) Syndrome
- Wernicke is an encephalopathy
- Korsakoff is a psychosis
- Psychosis induced by Vitamin B1, thiamine deficiency
- This is a situation the pt looses touch with reality due to vit B1 deficiency
Wernicke (Korsakoff) Syndrome primary S/Sx
are amnesia (memory loss) and confabulation (making up stories)
o Confabulation—The lies for this pts are just as real as reality
How do deal with a pt with Wernicke and Korsafoff who is confabulating
Redirect the pt to something he can do
o For instance, tell pt something along that line: “Why can we go watch TV to see what is
on the news today”
Characteristics of Wernicke and Korsafoff syndrome
1.Preventable … Take B1
2.Arrestable (stop it from getting worse) … Take B1
3.Irreversible (70%) … Will kill brain cells
Disulfiram
Antabuse and Revia
Antabuse—Alcohol deterrent
Revia—Antidote
Med that causes pts who drink symptoms of n/v, even
death
duration of Disulfiram
2 weeks
Onset of Disulfiram
2 weeks
Patient teaching on Disulfiram
o Teach pt to avoid all forms of EtOH. Not doing so may lead to symptoms of n/v, even
death
o Teach them to avoid the followings items as they contain alcohol … Mouth wash,
cologne, perfume, aftershave, elixir, most OTC liquid medicine, insect repellant, hand
sanitizer, vanilla extract (can’t have cupcake with unbaked icing)
o On the exam, do not pick the Red Wine vinaigrettes … It does not have alcohol in it
First thing you ask in an overdose nclex Q
Is it a upper or downer
List of uppers
- Caffeine
- Cocaine
- PCP/LSD (psychedelics/hallucinogens)
- Methamphetamines
- Adderall
SS of uppers
- Things go UP!
- Euphoria, seizures, restlessness,
irritability, hyperreflexia (3+, 4+),
tachycardia, increased bowels
(borborygmi), diarrhea
SS of downers
- Things go DOWN!
- Lethargic, respiratory depression/arrest,
constipated, etc.
The highest priority to anticipate in an Upper is
suctioning due to seizures
The highest priority to anticipate in a Downer
intubation/ventilation
At birth, you should assume the baby is withdrawing or intoxicated?
Intoxicated within 24hours
Every alcoholic goes through alcohol withdrawal approximately
24 hours after the person
stops drinking
Delirium tremens occurs about
72 hours after the person stop drinking
Nursing Care Plan Dt
NPO (seizures) or clear liquid diet
* Private room, near nursing station
* Restricted bed rest (Pt is not free to move
around as desired—no bathroom)
* Restraints (vest or 2-point lock letters)
Antihypertensive
Tranquillizer
Multivitamin containing B1
Nursing Care Plan AW
- Regular diet
- Semiprivate room, anywhere on the unit
- Pt is up ad lib (Pt is free to move around
as desired) - No restraints
Antihypertensive
Tranquillizer
Multivitamin containing B1
