Substance related disorders Flashcards
How to identify and recognise signs of addictions in nursing
practice?
- Hx
-PA: Vital signs, Stage of withdrawal, Nutritional status, Fluid balance, Circulatory-respiratory
status, Personal hygiene - Presence of (physical) Trauma
- Social assessment: Identification of existing or potential problems,
Family stability,
Occupational status,
Financial needs,
Need for referrals
How to monitor patients during withdrawal
phase?
Alcohol withdrawal assessment chart:
- motor impairment
- sleep disturbance
-apetite
- gi symptoms
- confusion
-hallucination
- pulse rate
-blood pressure
-sweating
-seizure
How to monitor patients during detox phase?
Goal: Promote comfort, relaxation
and prevent exacerbation of
symptoms
- Establish trusting relationship
- Assess level of anxiety
- Speak in simple language, short and easy to understand
- Observe of fluid balance
- Maintain patient safety
- Monitor withdrawal regularly, observe for seizures
- Provide quiet environment
- Avoid the attitude that creates a feeling of suspicion, give real
answers, be firm and friendly - Working together with the doctor in providing sedation
Which conditions would the nurse recognize as signs of alcohol
withdrawal?
a. Blackouts
b. Diaphoresis
c. Elevated blood pressure
d. Lethargy
e. Nausea
f. Tremulousness
b, c, e, f
Which behaviors would indicate stimulant intoxication?
a. Slurred speech, unsteady gait, impaired concentration
b. Hyperactivity, talkativeness, euphoria
c. Relaxed inhibitions, increased appetite, distorted perceptions
d. Depersonalization, dilated pupils, visual hallucinations
b
The nurse has provided an in-service program on impaired
professionals. She knows that teaching has been effective when staff
identify which as the highest risk for substance abuse among
professionals?
a. Most nurses are codependent in their personal and professional
relationships.
b. Most nurses come from dysfunctional families and are at risk for developing addiction.
c. Most nurses are exposed to various substances and believe they are not at risk of developing the disease.
d. Most nurses have preconceived ideas about what kind of people become addicted.
d
A client comes to day treatment intoxicated but says he is not. The
nurse identifies that the client is exhibiting symptoms of
a. denial.
b. reaction formation.
c. projection.
d. transference.
a
The client tells the nurse that she has a drink every morning to calm
her nerves and stop her tremors. The nurse realizes the client is at risk for
a. an anxiety disorder.
b. a neurologic disorder.
c. physical dependence.
d. psychological addiction
c
Terminologies definitions:
-substance abuse
-substance dependence
-tolerance
-physical dependence
-addiction
-withdrawal
Substance abuse: Repeated use of a psychoactive drug/alcohol, that doesn’t result in
compulsive use or addiction and
doesn’t lead to withdrawal symptoms when the drug’s use is
terminated
Substance dependence:
Compulsive, repetitive use of a psychoactive substance/alcohol
resulting in tolerance to the effects and withdrawal symptoms when drug/alcohol use is decreased or stopped
Tolerance: Decreased response to a drug that occurs with repeated use. A user who develops a tolerance to the
rewarding properties of the abused drug must take increasingly higher
amounts to get the desired effect.
Physical dependence:
An adaptive state that occurs as a normal physiologic response to repeated drug exposure; physical dependence doesn’t necessarily indicate drug abuse or addiction
Addiction: Compulsive use, impaired control over using substance, preoccupation with
obtaining and using the drug, and continued used despite adverse
consequences
Withdrawal
* An uncomfortable syndrome that occurs when tissue and blood levels of the abused substance decrease in a person who has used that substance heavily over a prolonged period.
* Withdrawal symptoms may cause the person to resume taking the substance to relieve the symptoms, thereby
contributing to repeated drug use.
