Substance Related And Addictive Disorders (Alcohol Use Disorder) Flashcards
Individuals are considered to have a substance use disorder when what ?
When the use of the substance interferes with the ability to fulfill obligations such as work, school, or home
What is Alcohol ?
A CNS depressant
How many stages of withdrawal are there ?
3 stages
What are the 3 stages of Withdrawal ?
Stage 1: Minor Withdrawal
Stage 2: Moderate to Severe Withdrawal
Stage 3: Most Dangerous Withdrawal: Delirium Tremens (DT’s)
When does Stage 1 of Withdrawal occur ?
Within 4-12 hours of cessation of drinking
What do the symptoms look like for a client in Stage 1 of Withdrawal ?
- Mild tremors
- Nervous
- Nausea
- Insomnia
- Headaches
- palpitations
What do you want to do for a client in stage 1 of Withdrawal ?
Orient to time, place, and person
What do the symptoms look like for a client in Stage 2 of Withdrawal ?
- Increased tremors
- Confused
- Hyperthermic
- Hyperactive
- Nightmares
- Increased BP
- Increased Respirations
- Hallucinations
- Illusions
Why do you want to carefully assess and provide treatment during Stage I and II of Withdrawal ?
To prevent the client from progressing to delirium tremens
Which stage of Withdrawal is considered a Medical Emergency ?
Stage III
What are most common in Stage III of Withdrawal ?
Kinesthetic DT’s (Delirium Tremens)
- Clients feel things crawling on them
What are possible in stage III of Withdrawal ?
Tonic Clonic Seizures
What are the Tx’s for Alcohol Use Disorder ?
- Keep the light on
- Encourage a close family or friend to stay with them
- Provide a quiet environment
- Walk and talk to them
- Orient the client frequently
- Clarify illusions
- Seizure precautions
- Anxiolytics (don’t be afraid to use them)
- Sedatives (like Benzo’s)
- Keep client well hydrated
- Prevent DT’s
- Disulfiram (Antabuse)
Tx’s: Alcohol Use Disorder
Why do you want to keep the light on for Alcohol Use Disorder clients ?
b/c clients are very scared
Tx’s: Alcohol Use Disorder
Why are Seizure Precautions implemented in client’s with Alcohol Use Disorder ?
Worry about Tonic-clonic seizures
_____________ is an anxiolytic that is frequently used for outpatient detox ?
Chlordiazepoxide (Librium)
Why should you not be afraid to give Alcohol Use Disorder client’s Anxiolytics ?
B/c the client has a cross-tolerance to other CNS depressants
Why are sedatives like Benzodiazepines used in the Tx of Alcohol Use Disorder ?
because they not only sedate, but they have anti-convulsant qualities
What is CIWA-Ar ?
An assessment tool that guides alcohol withdrawal medication dosing
Based on a CIWA-Ar assessment, treatment frequently begins when ?
And when may they be transferred to the ICU ?
When scores reach 8 - 10
Client may be transferred to the ICU for scores > 20
What electrolytes is an Alcoholic usually low in ? and why ?
Usually have low…
- Thiamine
- Magnesium
- Calcium
- Potassium
- Phosphorus
Because Alcoholics don’t eat or drink hydration fluids well
Tx: Alcohol Use Disorder
Because Alcoholic clients typically don’t eat or drink well, what type of replacements might be required (even during detox) ?
- Multi-vitamins
- Electrolyte solutions
- Thiamine injections
Thiamine is what type of vitamin ? and is needed for what ?
- Is a Complex vitamin
- Needed for good brain functioning
Thiamine deficiency can lead to what 2 chronic conditions ?
- Wernicke’s Encephalopathy
- Korsakoff’s Psychosis
What is Wernicke’s Encephalopathy ?
The most serious form of thiamine deficiency in alcoholics
Symptoms of Wernicke’s Encephalopathy include what ?
- Paralysis of the ocular muscles
- Diplopia
- Ataxia
- Somnolence
- Stupor
Alcoholic client’s with Wernicke’s Encephalopathy require what ?
What will happen without it ?
Require Thiamine Injections
Without, death will occur
What is Korsakoff’s Psychosis ?
Syndrome of confusion and loss of recent memory
When is Korsakoff’s Psychosis often seen ?
Often seen when the Alcoholic client is coming out of Wernicke’s Encephalopathy
What is it called when Wernicke’s Encephalopathy and Korsakoff’s Psychosis occur together ?
The two disorders are called Wernicke-Korsakoff syndrome when they occur together
What are the major defense mechanisms seen in Alcoholism ?
Denial & rationalization
What is Disulfiram (Antabuse) ?
Is a deterrent to Drinking
What must be done before Antabuse can be given ?
Client must sign a consent
A client receiving Antabuse must stay away from what ?
Stay away from any form of Alcohol
including. ..
- cough syrup
- aftershave
- colognes
- chemicals such as varnish
An Alcoholic client must have what once detox is over ?
must have Support
________ issues emerge once the client is sober ?
Family issues
–> Family therapy is important for all family members
What is effective for Alcoholics ?
12-step program is effective (ex: alcohol anonymous)
