Substance Abuse Flashcards
How is substance abuse defined?
The use of any chemical in a fashion inconsistent with medical or culturally defined social normals despite physical, psychological, or social adverse effects.
When does substance dependence occur?
When the individual can no longer control the use of the substance, continues to use despite adverse effects, and experiences withdrawal symptoms without continued use of substance.
What happens during kindling?
Long-term changes in brain neurotransmission that occurs after repeated detoxifications. Neuron sensitivity increases.
What occurs when neuron sensitivity increases due to substance abuse kindling?
Cravings for the substance increases with repeated detoxifications.
Why does substance abuse occur?
Due to humans seeking pleasure to avoid stress and pain
What are the risk factors of substance abuse?
- Male
- Loneliness, depression, low self-esteem
- Family history of addiction
- Peer pressure
- Presence of mental illness
- Lack of family involvement
- Using highly addictive drugs
What should you do as a nurse to keep clients safe is they are substance abusers?
- Do not ignore poor performance
- Do not lighten or change the nurses’ client assignment
- Do not accept excuses
- Do not allow yourself to be manipulated or fear confronting a nurse if client safety is in jeopardy.
Why are nurses at high risk for substance abuse?
Frequent contact with drugs
What do clinical manifestations depend on?
Amount
Frequency
Specific combinations of substances used
What does caffeine increase?
Heart rate and other negative cardiac effects
What does caffeine act as?
A diuretic
How many milligrams of caffeine is considered excessive?
600mg
If caffeine is combined with alcohol what is increased?
Accidental injuries
If caffeine addiction occurs what can result from abrupt withdrawal?
Headaches and irritability
What can cantabile act like?
Opioids causing a release of endogenous endorphins and dopamine
Based on the dose of cannabis what can it effect?
Respiratory system
Reproductive system
Birth defects
What does cannabis cause?
Sedation and hallucinations
Amotivational behaviors result from what?
Chronic long-term use of cannabis
What drug classes are considered CNS depressants?
- Barbiturates
- Benzodiazepines
- Paraldehyde
- Meprobamate
- Chloral hydrate
Cross dependence and cross tolerance occurs with all what?
CNS depressants
Barbiturates cause what upon accidental overdose?
Mild sedation to sleep to coma to death
Benzodiazepines are safer to do what?
They are safer to overdose on because they are less likely to cause death.
What causes cocaine and amphetamines to be so addictive?
The production of a euphoria type feeling.
Why does cocaine and amphetamines cause spontaneous abortion or fetal addiction?
Because it crosses the placenta
What are the mild symptoms of cocaine overdose?
Agitation
Tremor
Blurred vision
What are the severe symptoms of cocaine overdose?
Hyperpyrexia Convulsions Severe hypertension Dysrhythmias MI CVA
What does amphetamines cause?
Arousal and elevation of mood
What does chronic use of Methamphetamine cause?
Paranoia Hallucinations Compulsions Delusions Psychosis
True or False:
Methamphetamine is often taking by itself.
False:
It is often taken in combination with other drugs
What drugs are considered opiates?
Morphine Meperidine Codeine Hydrocodone Oxycodone
What are the problematic physiological effects of opiate use?
Hyperalgesia
Hypogonadism
Sexual dysfunction
What are the symptom of withdrawal from opiates?
Craving Lacrimation Rhinorrhea Yawning Diaphoresis
What is used as an effective medical intervention for a client under the influence of PCP?
Haloperidol
How do patients on PCP act?
Often violent and difficult to control
What does LSD effect?
Serotonin receptors throughout the brain
Does LSD have withdrawal symptoms?
No
What happens when someone is on LSD?
Tripping
Psychological effects
Flashbacks are common
What is considered an inhalant?
Anesthetics
Volatile nitrates
Organic solvents
Abusing inhalant can cause what?
Brain damage or sudden death with the first or 100th use.
Patient who abuse inhalants tend to have higher rates of what?
Mental health issues
What are the common organic solvents used as inhalants?
Gasoline
Nail polish remover
Lighter fluid
Paint thinner
What happens if a patient overdoses on an inhalant?
There is only supportive treatment due to no antidote
The effects of inhalants are similar to what?
Alcohol
What are the therapies used in treating a patient with substance abuse?
Detox Aversion therapy Group psychotherapy Meds CBT Family counseling Self-help groups
What are the diagnostic tests used to determine substance abuse?
Blood Urine Saliva Hair Sweat
What emergency care is used for a patient undergoing an overdose?
Treatment for respiratory depression
Seizures
Coma
What is important to do on assessment of a patient with substance abuse problems?
- Nonjudgemental atmosphere to promote trust and respect
- Health promotion efforts
- Comprehensive approach
- History of past substance use
- Medical, psychiatric history
- Psychosocial issues
What are the nursing diagnoses used in patients with substance abuse?
- Risk for injury
- Risk for violence
- Ineffective denial
- Ineffective Coping
- Chronic or Situational Low Self-Esteem
- Deficient Knowledge
- Disturbed Sensory Perceptions
- Disturbed thought processes
- Imbalanced nutrition
What are the short term goals for a patient with substance abuse problems?
- Admit having a problem
- Will seek help to stop using substance
- Will suffer no complications of drug withdrawal
- Will enter drug rehab program to change behavior
What are the long term goals for a patient with substance abuse problems?
- Will explore impact of addiction
- Will described, recognize use of denial
- Will change thinking and behavior
- Will regularly attend support group
- Will remain free of substance and maintain sobriety
What should the nurse implement with a substance abuse patient?
- Promote safety
- Promote adherence to treatment
- Promote healthy coping skills
- Promote adequate nutrition
- Promote healthy self-esteem
- Provide client education
- Promote client safety during withdrawal.
What should be included in the evaluation of a client with a substance abuse problem?
- Suffers no complication from withdrawal
- Admits problem with substance abuse
- Seeks help
- Enters substance abuse program
- Can described choices that contributed to substance abuse
- Attends daily support group meetings
- Remains substance free
