Mental health- substance abuse Flashcards
addiction is what
primary
involves what
“primary chronic disease of brain reward, motivation, memory, and related circuitry
involves dopamine and glutamate in the pleasure pathway of the limbic system in the brain
types of addictions
alchohol
Gambling
Shopping
Sexual
Social Media/Internet
Addiction
what type
cycles
unable
unwilling
chronic medical condition
cycles of relapse and remission
unable to consistently abstain from substance
unwilling to recognize the extent of the ,addiction
Intoxication-
when what
considered
when people use a substance to excess
considered when they are high, drunk or under influence
Tolerance:
when
needs
when a person no longer responds to the substance the same way they used to- build up tolerance
needs more to get same result
Alcohol Dependence:
person
haves
person feels uncomfortable when they don’t have the substance-
haves cravings
Withdrawal-
set
the more intense the symptoms
set of symptoms when a person stops using The substance
the more intense the symptoms are, the more likely they are to start substance again
Co-dependence-
when
when someone is trying to quit->
when they rely on others to do things they could do themselves- like adls/ work
when someone is trying to quit its important to make sure they do as much as they can for themselves
Detoxification-
removing
removing the harmful substances from the body
What are the causes addiction?
Neurotransmitters decreased (dopamine, serotonin)
Genes account for approximately 50% of an individual’s risk of becoming addicted
Adverse childhood experiences are a major factor underlying addiction!
Environment / Social
cost of caring
it is important
Addiction is hard on the caregiver too!
Cost of caring for another person with an addiction is emotional, physical, and tiring
It is important to remain nonjudgmental.
You can develop compassion fatigue!
viewing addiction
failure to
need to see
Addiction is hard on the caregiver too!
Viewing addiction as a character weakness
Failure to identify readiness for change or failure to help because the belief that nothing will help
Need to see success stories if we always are seeing the patient’s rock bottom, we also need to see good outcomes.
Risk Factors with alcohol abuse
what gene
what gender
possible low levels of what
Gene associated with alcoholism and dependency
Females tend to drink less than males
Possible low levels of dopamine and serotonin
Risk Factors with alcohol abuse
Common factors:
hx of what
Hx of sexual/physical abuse
Hx of depression, anxiety, antisocial and dependent personalities
Risk Factors with alcohol abuse
what ethnicitys
what religion
caucasians , hispanics, African Americans
Roman Catholics
who drinks the least amount of alcohol
jewish and asian Americans
AUDIT (Alcohol Use Disorders Identification Test)
what score indicates problem
Screening / Risk Assessments
Score of 7 or more (8 for men) = indicate problem
Alcohol Intoxication-what causes
large
can result in
large amounts of alcohol in a short amount of time
can result in death from emesis or body shutting down
Alcohol Intoxication-Signs and symptoms
inability
what skin
what rr
what skin
potential
inability to arouse pt
cool clammy skin
rr less then 10
cyanotic
potential emesis
Alcohol Intoxication Treatment-
do what if possible
induce
ac
vs how often
keep awake if possible
induce vomiting
activated charcoal
vs every 15 minutes
Alcohol Intoxication Treatment if in coma state/blacked out-
make sure
establish
iv
g l
what precautions
potential
make sure airway is clear
establish an airway
iv fluids
gastric lavage
seizure precautions
potential dialysis
Onset: alchohol withdrawal
Within a few hours (6 hours) after stopping
First sign is
how long after
alchohol withdrawal
: tremors shakes/ jitters-
6-8 hrs after alcohol cessation
s/s of alcohol withdrawal
a
lack
n
v
impaired
agitation
. Lack of appetite,
Nasua,
vomiting,
Impaired cognition
peak time in alcohol withdrawal
24-48 hrs after
monitor what in alcohol withdrawal
how long after
Monitor seizures
12-24 hrs after
alchohol withdraw
could lead to what condition in what time
a
lack
impaired
what 3 vs
DTI- medical emergency in first 72 hrs
agitation
lack of appetite
impaired cognition
increased bp/pulse/ temp
Alcohol Withdrawal initially watch for
x2
Seizures
Delirium tremens
nursing care alchohol withdrawal
use waht to asses
teat w/
t
do waht w hallucinations
take waht
/
decrease
nutrition->
Use CIWA scale to assess
treat w/ benzos
Telemetry
Hallucinations-orientate to reality
Vitals signs
Intake / Output
Decrease stimuli in environment
Nutrition-make sure getting all electrolytes
Alcohol Withdrawal – Delirium Tremens
manifested by:
altered
sympathetic
can progress to
altered mental status
sympathetic overdrive
, can progress to cardiovascular collapse
delirium tremems
is what
what morality rate
making what
medical emergency
with a high mortality rate,
making early recognition and treatment essential
Delirium peaks at
Alcohol Withdrawal – Delirium Tremens
2-3 (48-96 hours) days after cessation or reduction of intake and can last 2-3 days.
Manifestations- Alcohol Withdrawal – Delirium Tremens
hr
d
f
a
I
bp
tachycardia,
diaphoresis,
fever,
anxiety,
insomnia,
hypertension
Outcome – What is priority?
Alcohol Withdrawal – Delirium Tremens
–safety and getting back to baseline without injury
prevention of withdrawal delirium- benzos
what 3 meds-
- diazapem,
chlodipazoxide,
lorazpaem
Alcohol Withdrawal Vitamin Deficiency
a
f
t
Albumin
Folic Acid
Thiamin
Alcohol Withdrawal Electrolyte deficiency
what 3
Hypokalemia
Mg
Ph
Alcohol Withdrawal Other deficiencies:
lower
hypo
Lower T helper cell
Hypoglycemia
Alcohol Withdrawal What food would be best?
fortified cereals
Alcoholism rehabilitation programs
what program
what is goal
Alcohol long-term concerns
Alcoholics Anonymous meeting (AA) 12-step program
Goal: The patient is responsible for his or her own behavior
Abstinence Medications- Disulfiram (Antabuse)-
prevents
cannot
pt will
Alcohol long-term concerns
Prevents breakdown of alcohol, diminishes cravings
Cannot have any product with alcohol (mouthwash)
Patient will get immediately ill if take any alcohol
naltrexone
used for x2
opioid free for how long
nausea goes away after
used for-, relapse prevention
needs to be opiod free for 10 days
nausea goes away after 1 month
acamprosate calcium
used for
begin taking when
s/e
contraindicated when
used for relapse prevention
begin taking on 5th day of abstinence
s/e-gi upset, dizziness, anxiety
contraindicated in renal impairment
Stage 1 of transtherical model- pre contemplation
pt
pt needs help admitting thye have a problem
Stage 2 of transtherical model- contemplation
admit
admit they have problem but wont commit to being done
Stage 3 of trasntherical model-preparation
notices
notices family is affected and will commit to change behavior
Stage 4 of transtherical–maintenance
ongoing
ongoing commitment to changing behavior- like Alcoholics anonymous
Wernicke-Korsakoff Syndrome (also called wet brain) Encephalopathy (Wernicke’s) – Thiamine deficient (malnutrition)
altered
what dysfunction
c
eyes
Alcohol long-term concerns
alerted gait,
vestibular dysfunction.
Confusion,
ocular motility abnormalities- nystagmus, gaze palsy)
Alcohol long-term concerns-Erosive gastritis-
/
loss
b
b
may lead to x2
n/v
loss of appetite,
belching,
bloating
may lead to ulcers and bleeding
Alcohol long-term concerns
Pancreatitis- pancreas damage,
what pain
n
v
in early stages what helps
ab pain, nausea, vomiting
in early stages- withdrawal can help///
Alcohol long-term concerns
Pancreatitis- pancreas damage
chronically may result in
m
w
d
malnutrition,
wt loss,
diabetes
Alcohol long-term concerns
Increase risk of
breast cancer
Alcohol long-term concerns
Chronic Liver disease
b
b
p
j
a
e
wt
what vessels
bleeding,
bruising,
pruitis
, jaundice,
ascites,
edema,
wt loss,
spider like blood vessels
Caffeine
most
is it official
effects start when
Most widely used
Not an official disorder
Effects start within 15 minutes
Caffeine intoxication S/S Behavior symptoms,
r
n
e
a
speech
restlessness
nervousness
excitement
agitation
rambling speech
Caffeine intoxication S/S Physical symptoms:
face
d
gi
msucle
hr
cardiac
flushed face,
diuresis,
GI disturbances,
muscle twitching
tachycardia,
cardiac arrhythmia
CaffeineLethal overdose:
rare in what
more likely in what
rare in coffee and tea, more likely in energy drinks /
CaffeineLethal overdose:
characterized by
f
hr
bp
fever,
tachcyardia/bradicaridia,
and hypretension followed by hypotension
CaffeineLethal overdose:
extremely high can cause
seizures
death
treatment for caffeine overdose
h
g l
a c
what if hr and what if bp
hydration
, gastric lavage
activated characoal,
beta blockers if tachycardia and vasopressors is bp
CNS Stimulants: Nicotine
E cigs
dangerous for who
can buy where
abuse is
Dangerous for adolescences, gateway drug!
can buy online
abuse is high for self medication
CNS Stimulants: Crack/Cocaine
How does it work?-
makes pt feel good about themselves
CNS Stimulants: Crack/Cocaine
What are the signs of intoxication?
very
what pain
Very high paranoia about everything
chest pain,
CNS Stimulants: Crack/Cocaine
Are there any medical uses for cocaine?
nose bleeds
What is the most prescribed medication in the US?
–morphine codeine herion
OPIODS
Opiates: Intoxication
what pulse/bp/rr
s
c
what pupils
what mood
Decreased pulse/ BP/ rr
Sedation
Calmness
Pinpoint pupils
withdrawn mood
Opiates: Withdrawal
mood
and
d
muscle
f
I
r
puppilary
y
Mood dysphoria
Nausea and vomiting
Diarrhea
Muscle aches
Fever
Insomnia
Rhinorrhea (runny nose)
Pupillary dilation
Yawning
Overdose- Opioids
un
slow
c
hypo
hypo
unresponsiveness,
slow respiration,
coma,
hypothermia,
hypotension
treat opioid overdose with
with naloxone
other treatments for opioid overdose
Suboxone (buprenorphine and naloxone)
Zubsolv
Methadone
Medical uses for Marijuana
c
g
a
m
m
Chemotherapy associated nausea and anorexia
Glaucoma
AIDS
MS
Migraines
Marijuana: Concerns:
what drug
not
long
Gateway drug
Not knowing what is in the drug, what it’s mixed with
Respiratory long-term effects
Marijuana: Cannibas intoxication-
expeirence
see
time
motor skills
expeiernce brighter colors
, see new details,
time goes slower,
motor skills are impacter- don’t use machines,
Marijuana:
2 of the following symtpms are needed for diagnosis of intoxication
what eyes
increased
mouth
hr
- red eyes,
increased appetite,
dry mouth,
tachycardia
Marijuana /Cannabis withdrawal- occurs after a week s/s are
I
a
a
a
r
what mood
irritbiltiy,
anger,
aggression,
anxiety,
restless
depressed mood/
physical symptoms are
what pain
s
s
f
c
h
marijuana withdrawal
ab pain,
shakiness,
sweating,
fever,
chills
headache
Marijuana Treatement is
absitence and support
Methamphetamine medical use
ADHD
Methamphetamine
homemade meth
meth and ice
Methamphetamine Intoxication manifestations
Tachypnea, tachycardia
Methamphetamine Long-term effects
can destroy lives- can age terribly
Hallucinogens types
LSD, PCP, club drugs, mushrooms, ecstasy
Hallucinogens Intoxication symptoms
Commonly seen in hallucinogens
p
impaired
de
de
-Paranoia
impaired judgment
depersonization
derealizatoion
Hallucinogens- commonly see what
I
h
sy
prominent
illusions,
hallucinations,
synethesia(seeing sounds or hearing colors)-
prominent in this type of intoxication
Hallucinogens
physical symtpms are
pupil
hr
s
p
vision
t
in
pupillary dilation,
tachycardia,
sweating,
palpations,
blurred visions,
tremor,
incoordination
hallucinogens treatment
talking the pt down
Inhalants Types
Gasoline
Whipping cream
Paint
Glues
Hair sprays
Inhalants High doses/ intoxications causes
f
I
h
distorted
fearfulness,
illusions,
hallucinations
distorted body image
Inhalants intoxication Physical symptoms
n
a
n
relfexes
d
nausea,
anorexia,
nystagmus,
depressed reflexes
diplopia
Inhalants What are signs that someone is huffing?-
ring around face
Inhalants can cause
Can cause brain damage!
Teaching for other drugs
when do we start
how
kids before middle school and high school
education/ doing group activities/ giving kids positive coping mechanisms
