Substance Abuse Flashcards
Three days ago, a client was admitted to the medical unit for a gastrointestinal (GI) bleed. His BP and pulse rate gradually increased, and he developed a low-grade fever. What assessment data should the nurse obtain? What kind of anticipatory planning should the nurse develop?
- Obtain a drug and alcohol consumption assessment, including type, frequency, and time of last dose or drink.
- Call the health care provider and report findings.
- Anticipate withdrawal and DTs (delirium tremens = a severe, sometimes fatal, form of delirium d/t alcohol withdrawal following a period of sustained intoxication)
- Provide a quiet, safe environment
- Place on seizure precautions
- Anticipate giving a medication such as Librium
What physical signs might indicate that a client is abusing intravenous medications?
Needle track marks; cellulitis at puncture site; poor nutritional status
What behaviors would indicate to the nurse manager than an employee has a possible substance abuse problem?
Change in work performance, withdrawal, increase in absences (especially Mondays and Fridays), increase in number of times tardy, long breaks, lateness returning from lunch
A client becomes extremely agitated, abusive, and very suspicious. He is currently undergoing detoxification from alcohol with chlordiazepoxide (Librium) 15 mg every 6 hours. What nursing actions are indicated?
Notify the health care provider immediately and anticipate an increase in dose or frequency of Librium. Provide a quiet, safe environment. Approach in a quiet, calm manner. Avoid touching client.
A client in the third week of a cocaine rehabilitation program returns from an unsupervised pass. The nurse notices that he is euphoric and is socializing with the other clients more than he has in the past. What nursing actions are indicated?
Notify health care provider of observed behavior change. Get a urine drug screen as prescribed. Confront client with observed behavior change.
