Overdose & Withdrawal

Question 1

What are “upper” drugs

Answer 1

Caffeine
Cocaine
PCP/LSD (psychedelics/hallucinogens)
Methamphetamines
Adderall

Question 2

What are signs ans symptoms of “upper”(s)

Answer 2

Euphoria, seizures, restlessness, irritability, hyperreflexia (3+, 4+), tachycardia, increased bowel sounds (borborygmi), diarrhea

Question 3

What are exampels of downers

Answer 3

Opiods
Xanax
Heroin
Alcohol
Marijuana

Question 4

What are signs and synptoms of downers

Answer 4

Lethargic, respiratory depression/arrest, constipated, etc.

Question 5

What is the nurse’s higest priority to anticipate in an Upper?

Answer 5

Suctioning due to seizures

Question 6

What is the nurse’s higest priority to anticipate in a Downer?

Answer 6

Intubation/ventilation due to respiratory arrest

Question 7

The driver of a squad car calls the ER and says he is bringing a pt who in ODed on cocaine. What do you expect to see?

Answer 7

Irritability, 4+ reflexes, borborygmi, increased temperature, etc.
Upper GD looks like downer withdrawal

Question 8

Occurs after 24 hours after drinking
Non-life threatening to self and others

Answer 8

Alcohol Withdrawal Syndrome

Question 9

• Occurs after 72 hours after drinking
• Life threatening to self and others

Answer 9

Delirium Tremens

Question 10

Nursing Care Plan with Alcohol Withdrawal

Answer 10

• regular diet
• semiprivate room, anywhere on the unit
• pt is up ad lib (pt is free to move around as desired)
• no restraints

Question 11

Nursing Care Plan for Delirium Tremens

Answer 11

• 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 sor 2-point lock letters)

Question 12

What to give to both Alcohol Withdrawal Syndrome and Delirium Tremens

Answer 12

anti-HTN medication, tranquilizer, multivitamin containing vit B1

Question 13

What should you look out for Withdrawal of an Upper?

Answer 13

Respiratory Arrest

Question 14

What look look out for withdrawal of a downer?

Answer 14

Seizure

Question 15

What do we monitor in a client receiving continuous infusion of norepinephrine?

Answer 15

BP, Intravenous site, Urine output, Blood glucose

This medication is a vesicant, preferred route is central line. Therefore if through peripheral IV, asess for extravasation frequently.
Monitor BP to assess desired response to increased vascular tone.
Monitor Ins and Outs because this medication causes vasoconstriction, decreasing renal blood flow and decreasing urine output.
Minotor glycogen because Norepinephrine has an ability to cause liver to discharge more glucose by breaking down glycogen.