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Psych Exam 2 > Substance Abuse > Flashcards

Substance Abuse Flashcards

1
Q

substance use disorder

A

addiction

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2
Q

substance induced disorder and etc.

A

disorders associated with the use of substances

intoxication, withdrawal, delirium, neurocognitive disorder, psychosis, and can create other psychiatric conditions including anxiety, OCD, depression, psychosis, bipolar, sexual dysfunction and more

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3
Q

crucial part of how this develops
Pathologically pursuing reward and/or relief by substance use and other behaviors.

A

brain reward system

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4
Q

personal side effects to substance addiction

A

*Interferes with ability to fulfill role/obligations
*Attempts to cut down or control use fail
*Intense craving for the substance
*Excessive amount of time spent trying to
Procure substance
Recover from use
*Difficulty with interpersonal relationships or social isolation
*Engagement in risk taking activities when impaired
*Tolerance develops – amount required to achieve desired effect increases
*Substance specific symptoms occur upon discontinuation of use

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5
Q

a state of disturbance in cognition, perception, behavior, level of consciousness, judgement, and other functions that is directly attributable to the effects of a psychoactive drug

A

intoxication

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6
Q

reversible syndrome of symptoms after excessive use of substance
direct effect on CNS

A

substance intoxication

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7
Q

Abrupt reduction or discontinuation of a substance used regularly over a prolonged period of time

A

substance withdrawal

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8
Q

Clinically significant s/s as well as psychological changes such as disruption in thinking, feeling and behavior
Often substance specific features

A

substance-specific syndrome

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9
Q

substances for possible addiction

A

COFFEE, alcohol, cannabis, hallucinogens, inhalants, opioids, sedative-hypnotics, or anxiolytics, stimulants and tobacco or nicotine

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10
Q

biological factors as predisposing factors for substance use

A

genetics
biochemistry

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11
Q

psychological factors as predisposing factors for substance use

A

Developmental Influences
Cognitive Factors
Personality Factors
Sociocultural Factors
(Social Learning, Conditioning, Cultural and Ethnic Influences)

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12
Q

Phase I of alcohol use disorder

A

Pre-alcoholic Phase
Relieving everyday stress or tensions

Tolerance may build up and it takes one drink initially and later 2 or 3 to get the desired effect.

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13
Q

Phase II of alcohol use disorder

A

Early alcoholic phase
Blackouts

No longer a pleasure but a craving builds.
Blackouts are common. Sneaking drinks.
Guilt and defensiveness start to be common coping mechanisms.
Denial and rationalization common

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14
Q

phase III of alcohol use disorder

A

The crucial phase
Lost ability to choose whether to drink
Extremely ill

No longer a pleasure but a craving builds. Blackouts are common. Sneaking drinks. Guilt and defensiveness start to be common coping mechanisms. Denial and rationalization common
Phase III: Lost control of use completely and addiction is evident. Binge drinking for hours or days even occurs. Individual is very ill in this phase. Anger and aggression are common manifestations. Drinking is the sole focus and the person is willing to risk everything for the drink. Often in this phase, loss of job, marriage, family, friends and self-respect are noted.

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15
Q

phase IV of alcohol use disorder

A

The chronic phase
Emotional and physical disintegration
Helplessness and life-threatening physical

Emotional and physical disintegration. Person is usually intoxicated more often than not and emotional disintegration is evidenced by profound helplessness and self-pity. Impaired reality testing may result in psychosis. Withdrawal triggers symptoms of hallucinations, tremors, convulsions, severe agitation, and panic.

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16
Q

Nerve damage resulting in pain, burning, tingling, prickly sensation in extremities.
due to vit B deficiency

A

peripheral neuropathy

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17
Q

B vitamin deficiency mediated effects of alcohol

possible symptoms:

A

alcoholic myopathy

sudden onset of pain in muscles, swelling, weakness and myoglobinuria

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18
Q

Most serious form of Thiamine deficiency.

A

Wernicke’s encephalopathy

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19
Q

Syndrome of confusion, loss of recent memory, and confabulation.

A

Korsakoff’s Psychosis

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20
Q

physiologic effects of alcohol

A

esophagitis
esophageal varices
alcoholic cardiomyopathy
gastritis
pancreatitis
alcoholic hepatitis
leukopenia
thrombocytopenia
sexual dysfunction

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21
Q

End stage of alcohol liver disease and results from long-term chronic alcohol abuse. Widespread liver destruction replaced by fibrous (scar) lesions.

A

cirrhosis of the liver

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22
Q

complications of cirrhosis of the liver

A

Portal Hypertension
Ascites
Esophageal Varices
Hepatic Encephalopathy

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23
Q

alcohol intoxication in blood alcohol levels

A

between 100-200

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24
Q

Within 4-12 hours of cessation of or reduction of alcohol in heavy/prolonged alcohol use

A

alcohol withdrawal

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25
priority interventions for alcohol withdrawal
Help the client express their feelings directly and openly for 30 min at least twice a day Engage in self-evaluation to describe strengths and areas that support or development is needed and use journaling daily to record. Verbalize their process for solving problems to staff Practice nonchemical alternatives to dealing with acute stress and difficult situations with the goal of identifying and practicing at least three skills during their inpatient stay.
26
implementation of skills for alcohol withdrawal
Focusing on the here and now and what the client can do to redirect their behavior and life Guide the client to the conclusion that sobriety is a choice they can make If self-evaluation identified areas in which the patient needs support and development, ensure that resources are arranged upon discharge for this to happen Validate when the patient is able to problem solve more clearly and help the client find acceptable ways to express feelings with positive reinforcement as they practice these techniques.
27
sedative/hypnotic use disorder drugs
Barbiturates Nonbarbiturate hypnotics Antianxiety agents Club Drugs
28
examples of barbiturates
phenobarbital
29
examples of nonbarbiturate
Estazolam, Restoril, Halcion, Lunesta, Zolpidem or Ambien – referred to as sleepers
30
examples of antianxiety agents
Xanax, Clonazepam, Diazepam, Lorazepam are most common. Green and white pills. Color often helps determine dose.
31
examples of club drugs
Flunitrazepam, GHB commonly called Roofies, Liquid X, GHB, and rope or Rohypnol
32
One drug results in lessened response to other drugs
cross tolerance
33
One drug can prevent withdrawal symptoms related to physical addiction to another drug
cross-dependence
34
effects of sedatives and anxiolytics on the body
Sleep and dream Respiratory depression Cardiovascular effects Renal function Hepatic effects Body temperature Sexual dysfunction
35
timing of symptoms for short acting sedatives
symptoms can begin in 12-24 hours and peak at 24-72 hours finally subsiding at 5-10 days
36
timing of symptoms for sedatives with longer half-lives
it may take 2-7 days for symptoms to start and they peak at day 5-8 but subside after 10-16 days.
37
symptoms of autonomic hyperactivity
(sweating and pulse greater than 100), increased hand tremors, insomnia, nausea, vomiting, hallucinations, illusions, psychomotor agitation, anxiety, and seizures and delirium
38
psychomotor stimulation
Augmentation or potentiation of norepinephrine, epinephrine or dopamine
39
stimulants effects on the body
CNS System (Tremor, restlessness, insomnia and agitation) Cardiovascular/Pulmonary (Increased BP, HR, Arrythmias Relax bronchial smooth muscles) Gastrointestinal and Renal (Constipation and difficulty urinating) Sexual Dysfunction (Increased urges)
40
signs of amphetamine and cocaine intoxication
Euphoria, impaired judgement, confusion and changes in vital signs Coma and Death possible
41
signs of caffeine intoxication
jittery and shaky Restlessness and insomnia common
42
withdrawal symptoms of Amphetamine and cocaine withdrawal:
Dysphoria, fatigue, sleep disturbances and increased appetite
43
symptoms of caffeine withdrawal
Headaches, fatigue, drowsiness, irritability, muscle pain/stiffness, nausea and vomiting
44
nicotine withdrawal symptoms
Dysphoria, anxiety, difficulty concentrating, irritability, restless, increased appetite
45
cues for stimulant withdrawal
agitation, mood swings, disorientation, seizures, hallucinations, physical pain and discomfort, hostile behavior, uncooperative, disturbance in concentration, attention span or ability to follow direction
46
priority nursing interventions for pt with stimulant withdrawal
Safety of the patient – keep free of injury Reduce aggression and hostile behaviors Respond to reality orientation Verbalize and express fear and/or anxiety
47
possible implementation for pt with stimulant withdrawal
It may be necessary to assign patient to 1:1 or closer observation Seizure precautions may be needed Decrease environmental stimuli when the client is agitated – may need time in their room Avoid lengthy interactions Keep your voice soft even when they are loud Speak clearly – which is hard with a mask on – but this is a frustration for many patients Do not moralize or chastise the client for substance abuse. Maintain a nonjudgmental attitude Talk to the patient in simple concrete language Reorient the patient as needed when they become confused.
48
cannabis use effects on the body
Cardiovascular Respiratory Reproductive CNS Sexual Functioning
49
signs of cannabis intoxication
Impaired motor coordination, euphoria, anxiety, sensation of slowed time, and poor judgement Conjunctival injection, increased appetite, dry mouth, tachycardia Impaired motor skills 8-12 hours
50
signs of cannibas withdrawal within the week of cessation
Irritability, anger, or aggression Nervousness, restlessness, or anxiety Sleep difficulty ( insomnia, disturbing dreams) Decreased appetite or weight loss Depressed mood Physical symptoms such as abdominal pain, tremors, sweating, fever, chills, or headache
51
cues for cannabis withdrawal
Frequent use, denial of implications of substance use, exacerbation of symptoms, failure to keep appointments, poor impulse control, incongruence between therapeutic regimen and personal values or desires, knowledge deficit or skill deficit, lack of motivation for change.
52
priority nursing interventions for cannabis withdrawal
Verbalize the need for compliance with treatment plan Take medications as directed Identify difficulties associated with substance use Refrain from substance use
53
implementation for cannabis withdrawal
Discuss pattern of relapse in a non-judgemental manner Encourage the client to ask questions if they are uncertain about treatment plan If patient is having symptoms such as difficulty sleeping, encourage them to tell staff as they might be symptoms we can assist with Give positive feedback for honest reporting and recognize progress no matter how small
54
plans of care for cannabis withdrawal
Patient will verbalize knowledge of substance abuse as a disease Patient will verbalize risks related to drug ingestion Patient will accept referral for treatment outpatient with appointments set prior to discharge Patient will abstain from the use of substances
55
opioid use disorder effects on the body
CNS Effects Euphoria, drowsiness, mental clouding Gastrointestinal Effects Decreased peristaltic activity Cardiovascular Effects Hypotension Sexual Functioning Effects Decreased functioning Decreased libido
56
s/s of opioid intoxication
Consistent with the half-life of most opioid drugs Usually last for several hours Initial Euphoria followed by apathy, dysphoria, psychomotor agitation or retardation, and impaired judgement
57
SEVERE opioid intoxication signs
resp depression coma death
58
short acting opioid withdrawal symptom timing
Symptoms occur within 6-8 hours, peak within 1-3 days and gradually subside 5-10 days
59
long acting opioid withdrawal symptoms occur when
Symptoms occur within 1-3 days, peak between 4-6 days and subside in 14-21 days
60
ultra short acting opioid withdrawal symptoms occur when
Symptoms begin quickly, peak 8-12 hours and subside in 4-5 days
61
opioid withdrawal symptoms:
Dysphoria Muscle aches Nausea/Vomiting Lacrimation (tearfulness) or rhinorrhea Pupillary dilation Piloerection (goose bumps) Sweating Abdominal cramping Diarrhea Yawning Fever Insomnia
62
steps to the nursing assessment for a pt dealing with addiction
Examine your feelings, attitudes, and personal experiences and bias Motivational Interviewing techniques Drug history and assessment Become comfortable asking hard questions without judgement Clinical Institute Withdrawal Assessment for Alcohol Scale or CIWA CAGE Questionnaire for assessment of alcohol use disorder Clinical Opiate Withdrawal Scale or COWS
63
CAGE alcoholism screening
-Concern by the person that there is a problem -Apparent to others that there is a problem -Grave consequences -Evidence of dependence or tolerance
64
questions of the CAGE alcoholism screening
-have you ever felt that you should CUT down on the drinking? -have you ever become ANNOYED by criticisms of your drinking? -have you ever felt GUILTY about your drinking? -have you ever had a morning EYE OPENER to get rid of a hangover?
65
Coexisting substance disorder and mental health disorder
dual diagnosis
66
program combing cognitive and behavioral disorders
CBT
67
Desired clinical outcomes for nursing interventions include “the client”:
Has not experienced physical injury Has not caused harm to self or others Verbalizes responsibility for behavior Demonstrates adaptive coping mechanisms they can use in stressful situations Shows no signs of infection or malnutrition Verbalizes importance of abstaining from use of substances to maintain optimal wellness
68
evaluation of pt recovering from substance use disorder
Has detox occurred without complication? Is the patient still in denial? Does the patient accept responsibility for their own behaviors? Has a correlation been made between personal problems and substance use? Does the client still make excuses or blame others for their substance use? Has the client remained substance free during treatment?
69
therapy options for substance use disorders
Various support groups patterned after AA, but for individuals with problems with other substances too Counseling individually or with family Group Therapy CBT often used
70
Major Self-Help organization for treatment of alcoholism
Alcoholics Anonymous or AA
71
12 step process for AA
Specific guidelines on how to attain and maintain sobriety with tokens for duration of abstinence
72
may be required to reduce life-threatening effects including seizures associated with withdrawal
substitution therapy
73
pharmacotherapy for alcohol withdrawal
ativan protocols - benzos anticonvulsants multivitamin therapy thiamine (Vit B) Disulfiram (Antabuse) gabapentin SSRI’s Acamprosate (Campral) Naltrexone Nalmefene
74
narcotic antagonists
Naloxone or Narcan Naltrexone or RiVia Nalmefene or Revex
75
narcotic antagonists
Naloxone or Narcan Naltrexone or RiVia Nalmefene or Revex
76
opioids
Methadone Buprenorphine or Suboxone Clonidine
77
depressants
Phenobarbital (Luminal) Long-acting Benzodiazepines
78
stimulants
Minor and Major Tranquilizers Anticonvulsants Antidepressants

Psych Exam 2 (9 decks)

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