Mental health- substance abuse Flashcards by Logan Kaiser

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

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types of addictions

alchohol

Gambling

Shopping

Sexual

Social Media/Internet

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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

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Intoxication-

when what
considered

when people use a substance to excess

considered when they are high, drunk or under influence

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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

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Alcohol Dependence:

person
haves

person feels uncomfortable when they don’t have the substance-

haves cravings

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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

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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

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Detoxification-

removing

removing the harmful substances from the body

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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

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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.

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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.

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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

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Risk Factors with alcohol abuse
Common factors:

hx of what

Hx of sexual/physical abuse

Hx of depression, anxiety, antisocial and dependent personalities

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Risk Factors with alcohol abuse

what ethnicitys

what religion

caucasians , hispanics, African Americans

Roman Catholics

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who drinks the least amount of alcohol

jewish and asian Americans

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AUDIT (Alcohol Use Disorders Identification Test)

what score indicates problem

Screening / Risk Assessments

Score of 7 or more (8 for men) = indicate problem

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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

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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

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Alcohol Intoxication Treatment-

do what if possible
induce
ac
vs how often

keep awake if possible

induce vomiting

activated charcoal

vs every 15 minutes

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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

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Onset: alchohol withdrawal

Within a few hours (6 hours) after stopping

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First sign is
how long after

alchohol withdrawal

: tremors shakes/ jitters-

6-8 hrs after alcohol cessation

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s/s of alcohol withdrawal
a
lack
n
v
impaired

agitation

. Lack of appetite,

Nasua,

vomiting,

Impaired cognition

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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