Review two- ALCOHOLISM VS DELIRIUM Flashcards
what is the #1 problem with patients who have abuse probs
denial
denial def
refusal to accept the reality of the prob
how should a nurse respond to denial in pts with abuse issues
confrontation
how should a nurse respond to pts who have experienced a loss and are in denial
support
wernicke korskoff
psychosis induced by vitamin b1 or thiamine deficiency in alcoholics; psychosis
major s/s of wernicke korskoff
amnesia with confabulation
why is there no point in orienting wernicke korskoff pts
because they are not going to get better just distract or divert them
is wernicke korskoff preventable
yes vit b1 supplements
they can keep drinking
antebuse is an example of ___ therapy
aversion therapy
antebuse takes ___ weeks get in and out of system
2 weeks
what should pts taking antebuse avoid
all alcohol
- perfume
- mouthwash
- processed frosting
- aftershaves
- otc elixers
- insect sprays
5 uppers
- caffeine
- cocaine
- pcp/lsd
- meth
- adderall
upper s/s
everything goes up! euphoria tachycardia borborygmi diarrhea \+3/+4 reflexes spasitic seizure rx
downer s/s
everything goes down
overdose =
too much
withdrawl =
not enough
too little of an upper makes everything go down; too little of a downer makes everything go up
withdrawl
upper overdose looks like downer withdrawl; downr overdose looks like upper withdrawl
overdose
upper withdrawl ___ risk
resp distress rx
downer withdrawl ___ risk
seizure rx
upper overdose ___ risk
seizure rx
downer overdose ___ risk
resp distress rx
withdrawl in newborns:
always assume ___ not ___ at birth
intoxication not withdrawal
after 24hrs newborns must be watched for
withdrawal
every alcoholic goes through ____ ____ 24hrs q drinking
alcohol withdrawal
only a minority of alcoholics get ___
delirium tremens
delirium tremens occurs __ hrs after withdrawl
72hrs
___ sydrome always precedes ___ , ___ does not always follow ____.
alcohol withdrawal syndrome always precedes delirium tremens, delirium tremens does not always follow alcohol withdraw.
alcohol withdrawal pts are
stable
DT pts are
unstable
DT pts can be
dangerous
AWS diet
reg
DT diet
NPO; clear liquids; seizure precautions
AWS room type
semi private anywhere
DT room type
private near nurses station
AWS amublation
up and lib
DT ambulation
bedrest; no rr privileges
AWS restraints
none
DT restraints
2pt locked leathers; arm and leg opposites
both AWS and DT pts receive
- antihypertensive drug due to everything going up
- tranquilizer
- vit B1 multivitamin
aminoglycosides are
very strong antibiotics; last resort; dangerous
aminoglycosides; “a mean old mycin” to treat
a mean infection
all aminoglycosides end in mycin except
arithromyocin, zithromyocin, clarithromyocin
“if it ends in mycin its a mean old mycin but if it has throw, throw it out”
aminoglycosides are __toxic and ___toxic
ototoxic, nephrotoxic
monitor what s/s of ototoxicity
tinnitus, vertigo, hearing
monitor what s/s of nephrotoxicity
creatinine 24hr clearance
aminoglycosides are also toxic to cranial nerve number __
8
aminoglycosides cannot be administered
PO; causes hepatic encephalopathy and sterilizes bowel
who can sterilize my bowel?
NEOCAN! neomycin or canomycin
aminoglycosides are administered every
8hrs IM or IV
trough is
drug measured at lowest
peak is
drug measured at highest
digoxin lvls
0.8-2.0
draw drug troughs __ min prior to admin
30min
when to draw a sublingual drug peak
5-10 min q admin
when to draw IV drug peak
15-30 min q iv finishes
when to draw IM peak
30-60 min q admin
