Mental Health exam 3 Flashcards
substance use nursing history Q’s
- type of substance
- amount of substance
- pattern and frequency of use (look for changes)
- age at onset
- date of last substance use
- changes in occupational/school performance
- hx of abstinence periods
- previous withdrawal manifestations
rate of substance abuse is highest in ages
18-25
people at increased risk of substance disorder
- alaska natives
- native american groups
people at a decreased risk of substance disorder
asian groups
older adult indications of substance abuse
- decreased self care
- incontinence
- manifestations that look like dementia
opioid intoxication antidote
naloxone
opioid abstinence syndrome s/sx
- starts with sweating and rhinorrhea
- piloerection
- tremors
- irritability
- diarrhea
- weakness
- insomnia
- N/V
- pupil dilation
- muscle weakness/pain
- suicidal ideation
things BAC depends on
- weight
- gender
- alcohol concentration
- number of drinks
- gastric absorption rate
- tolerance level
when does alcohol withdrawal start?
4-12 hours after last drink
how long does alcohol withdrawal last?
5-7 days
when does alcohol delirium start?
2-3 days after last drink
alcohol delirium is considered a
medical emergency
nicotine abstinence syndrome s/sx
- cravings
- irritability
- nervousness
- restlessness
- anxiety
- insomnia
- anger
- depressed mood
- increased appetite
safety for substance use disorders
- prevent falls
- seizure precautions
- 1:1 observation (withdrawal)
- low stimulation
- monitor for covert substance use during detox
education for substance use disorders
- addiction
- initial tx goal
- removing unnecessary meds
- not sharing meds
emergency plan components
- what client needs to do
- who client needs to contact
12 step program
Alcoholics Anonymous (AA)
family groups
- Al-anon
- Ala-teen
what does a 12-step program teach?
- abstinence is needed for recovery
- a higher power can assist with recovery
- clients are not responsible for their disease, but are responsible for their recovery
- client cannot blame others
- client must acknowledge their feelings and problems
disulfiram: acetaldehyde syndrome s/sx
- N/V
- weakness
- sweating
- palpitations
- hypotension
what tests/labs should you monitor while taking disulfiram?
LIVER (hepatotoxicity)
should you take naltrexone with food?
yes to decrease GI distress
who should not take acamprosate?
pregnant women
what medication must be administered from an approved tx center?
methadone
what medication does not reduce the cravings of opioids?
clonidine
mild tension relieving behaviors
- finger/foot tapping
- fidgeting
- lip chewing
at what level of anxiety should gross motor activities be encouraged?
- severe
- panic
(walking)
how should you speak to those with severe/panic level anxiety?
- firm, short, simple, statements
- repetition
- slow, low-pitched, calm voice
generalized anxiety disorder criteria
uncontrollable, excessive worry
- majority of days
- at least 6 months
manifestations of separation anxiety
- during or in anticipation
- HA
- N/V
- sleep disturbances
how might people with specific phobias try to decrease anxiety?
alcohol or substances
panic attack criteria
- 15-30 minutes
- 4+ manifestations