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Psych Test 2 > Substance - Related & Addictive Disorders > Flashcards

Substance - Related & Addictive Disorders Flashcards

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1
Q

What are the four C’s of addiction?

A
  • Craving the substance
  • Loss of control of amounts or frequency of use
  • Compulsion to use
  • Despite consequences
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2
Q

Define intoxication.

A

Under the influence or high/positive feelings, Excess use of substance.

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3
Q

Define binge drinking.

A

Quickly drinking enough alcohol to make you intoxicated. May result in alcohol poisoning and can end in death.

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4
Q

Define tolerance.

A

Increased amount of substance needed to obtain the same affect. “He can hold his liquor”

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5
Q

Define withdrawal syndrome.

A

Decline of blood or tissue concentration of substance and physiologic symptoms occurred. Results in cravings leading to drug seeking of substance to prevent withdrawal symptoms.

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6
Q

What is the legal intoxication level for alcohol?

A

0.08 (clumsy movements)

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7
Q

What drugs are used to withdraw patients from alcohol?

A
  • Diazepam (Valium) Long Acting
  • Chlordiazepoxide (Librium) Long Acting
  • Lorazepam (Ativan) Short Acting but quick onset with IV admin
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8
Q

Why do use benzodiazepines to withdraw patients from alcohol?

A

Benzo’s increase GABA inhibitory effect on the brain when a person is withdrawing from alcohol, they also help prevent seizures and severe withdrawal (DT’s), benzodiazepines have a calming effect.

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9
Q

Should a person ever withdrawal cold turkey?

A

No

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10
Q

What is Suboxone?

A

A combo of buprenorphine and naloxone in pill and film form.

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11
Q

Should you ever inject suboxone?

A

No, the Narcan will cause immediate withdrawal.

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12
Q

What does naloxone do?

A

Reverses respiratory depression in opioid OD, requires immediate ER follow up

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13
Q

Why do you use suboxone?

A

As a risk reduction to reduce death rate.

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14
Q

The symptoms of craving for alcohol and opioids are similar to what?

A

OCD

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15
Q

What are three drugs used to prevent alcohol relapse?

A
  • Naltrexone (Trexan, ReVia)
  • A’cam’prosate (Campral)
  • Disulfiram (Antabuse)
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16
Q

What is alcohol aversive therapy?

A

You get sick if you drink alcohol.

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17
Q

Alcohol + disulfiram = ?

A

Hypotensive crisis

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18
Q

In order to take disulfiram (Antabuse) a patient must?

A

Be motivated not to drink, take daily, not ingest alcohol within 12 hours of taking Antabuse.

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19
Q

What is the cage aid questionnaire?

A

It screens for alcohol, illicit and prescription drug abuse

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20
Q

Define each letter of the cage aid questionnaire.

A 
" have you ever..."
C- Cut down use of drinking or drugs?
A- annoyed by others criticism?
G- Felt guilty about your use?
E- eye-opener ever needed?
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21
Q

A yes to one question in the cage-age questionnaire is a positive or negative screen?

A

Positive the nurse needs to do further screening

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22
Q

Define eye-opener.

A

Eye-opener means to use substance early in the morning to prevent withdrawal symptoms.

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23
Q

If a person has two addictions how do you treat them?

A

You treat both simultaneously.

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24
Q

What are four questions to ask on the specific use assessment?

A
  1. Route
  2. Quantity
  3. Usual pattern of use, occasional, monthly, weekly, daily?
  4. Time of last use
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25
Q

What is codependency?

A

Codependency results in over responsibility, the individual does for others and only sees one’s value in doing that.
Ask the spouse:
“Are you making lots of sacrifices for the other persons happiness, but not getting much in return?”

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26
Q

What are the physical signs of alcohol intoxication?

A

Loss of motor control and coordination, slurred speech, vomiting, double vision, low blood pressure, decreased and shallow respirations, ataxia.

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27
Q

What is a physical sign of alcohol poisoning?

A

Decreased and it’s shallow respirations, May lead to intubation, coma or death

28
Q

What are the psychological effects of alcohol intoxication?

A

Poor judgment, loss of memory, blackouts, decreased alertness, lack of inhibitions.

29
Q

What is a blackout?

A

No memory of what happened.

30
Q

What are the risk factors for addiction?

A

Genetics and social experimenting.

31
Q

When do signs of alcohol withdrawal develop?

A

Within a few hours after the last drink, approximately 2 to 6 hours.

32
Q

What are physical signs of alcohol withdrawal?

A

Diaphoresis, shaking, tremors, insomnia, nausea/vomiting, dilated pupils, clammy skin.

33
Q

When can grand mal seizures occur in alcohol withdrawal?

A

7-48 hrs

34
Q

When do signs of alcohol withdrawal peak?

A

24 to 48 hours

35
Q

If symptoms of alcohol withdrawal get worse, at 48 to 72 hours what comes next?

A

Delirium tremors

36
Q

What is the mortality rate with severe withdrawal delirium?

A

5%

37
Q

What are the symptoms of severe withdrawal delirium?

A
  • Hallucinations either visual, auditory, kinesthetic, or taste
  • Poor sleep, restlessness, nightmares
  • Seizures are possible 24 hours to one week after last drink
38
Q

DTs include what?

A

High fever, severe restlessness, agitation, tremors, rapid heartbeat, rapid breathing.

39
Q

What do you do if a patient has DT symptoms?

A

Call a doctor

40
Q

What is the clinical institute withdrawal assessment of alcohol scale revised ( CIWA-Ar) used for?

A

Assessment tool for symptoms of alcohol withdrawal.

41
Q

What are four goals of alcohol withdrawal/detox?

A
  • provide benzo’s for symptom triggered treatment
  • to reduce complications of withdrawal by providing nutritional needs, vitamin B1 and folate and thiamine
  • prevent alcohol withdrawal delirium with benzo’s
  • encourage rehabilitation to maintain abstinence
42
Q

What are three nursing cares for alcohol detox?

A
  • provide water
  • provide IV nutrition supplements ( thiamine, b1, folate)
  • assess patient’s symptoms using CIWA-Ar screen to know when to give benzo’s (symptom triggered treatment)
43
Q

What does alcohol use deplete?

A

Thiamine & vit B1

44
Q

Why must thiamine be given?

A

Depletion can cause brain damage thiamine must be given or the brain will not be able to make new memories.

45
Q

What is confabulation?

A

Because the patient is unable to make new memories related to thiamine deficiency, patient will fabricate memories without intention to deceive but is able to join in conversation.

46
Q

Define illusions as related to alcohol withdrawal symptoms.

A

These are not hallucinations they are misinterpretations of real objects in the environment in the early stages of withdrawal.

47
Q

What is the nursing care for a patient that is experiencing illusions from alcohol withdrawal symptoms?

A

Orient the patient and explain what they are seeing

48
Q

Patients that are experiencing alcohol withdrawal delirium need what type of observation?

A

One to one

49
Q

Every day how many people in the United States died from overdose of prescription painkillers?

A

44

50
Q

Opioids are also known as what?

A

Narcotics

51
Q

What is the major reason for death of a heroin user?

A

Respiratory depression due to overdose

52
Q

What are physical signs and symptoms of opioid use?

A

Pupil construction, slurred speech, impairment of attention or memory, drowsiness.

53
Q

How long do the symptoms of opioid use last?

A

4-5 hrs

54
Q

Withdrawal from narcotic/opioids May would occur within what timeframe?

A

4 to 12 hrs

55
Q

How long do the symptoms of withdrawal from narcotics/opioids last?

A

14 days

56
Q

What are the physical signs of narcotic/opioid withdrawal?

A

Muscle aches often in the legs and back, abdominal cramping, nausea vomiting, diarrhea, gooseflesh, runny nose, yawning, insomnia, tearing of the eyes.

57
Q

What is gooseflesh?

A

Bumps on the skin

58
Q

What is suboxone?

A

Buprenorphine and naloxone

59
Q

Is suboxone addicting?

A

Yes can cause respiratory depression if OD on it

60
Q

What does suboxone do for opioid withdrawal?

A

It relieves the withdrawal symptoms without the high.

61
Q

Why is naloxone added to buprenorphine to make suboxone?

A

It is added to prevent injecting the drug the person will go into immediate withdrawal.

62
Q

What is the cows scale?

A

Clinical opioid withdrawal scale, it evaluates withdrawal symptoms

63
Q

The amount of suboxone given is based on what?

A

The level of withdrawal symptoms.

64
Q

What is the difference between symptom triggered administration versus administration at a scheduled time?

A

Symptom triggered administration is given based on the level of withdrawal symptoms, giving medication at a scheduled time is given regardless of symptoms.

65
Q

Define a synergistic effect.

A

Enhances or intensifies the effects of another drug when certain drugs are taken together. Benzo’s and alcohol taken together will have a synergistic effect.

66
Q

What is an antagonistic effect?

A

When drugs are combined they weaken or inhibit the effect. CNS stimulants such as cocaine taken with a CNS depressant such as heroin will equal each other out.

67
Q

Define synesthesia.

A

Hallucination. Client hears a sound that results in the client seeing a color, the senses cross.

Psych Test 2 (6 decks)

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