Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3007 Final > Substance Use > Flashcards

Substance Use Flashcards

1
Q

Substance Use: The Role of the CHN

A
  • Develop and engage in health-promoting practice
  • Must understand dynamics, social and health effects, and root causes of substance use
  • Advocate for nursing practice that creates and embraces social justice
  • Practice intentionally, aiming at achieving social justice goals and outcomes that improve health experiences and conditions of individuals, their communities, and society
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is PRAXIS?

A
  • The process of using a theory or something you have learned in a practical way
  • In nursing, we use praxis to apply knowledge in nursing situations to advance goals in
    society and in the world, and to eliminate any injustice and discrimination in care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the proper term or phrase for substance abuse?

A

According to the DSM-5, Substance Use Disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is Substance Use Disorder?

A
  • Defined as mild, moderate, or severe
  • Determined by the number of diagnostic criteria met by the individual
  • Occurs when the recurrent use of alcohol or drugs causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at home, work, or school.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 4 basic categories of substance use disorder?

A
  • Impaired control
  • Physical dependence
  • Social problems
  • Risky use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the criteria that falls under the 4 basic categories of substance use disorder?

A
  • 1 criteria could indicate an individual at risk
  • 2-3 criteria point to a mild substance use disorder
  • 4-5 criteria show someone has a moderate substance use disorder
  • 6+ criteria indicates a severe substance use disorder which signals an addiction to that substance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

DSM-5: Substance Use Disorder Criteria

A
  • Using more of a substance than intended or using it for longer than you’re meant to
  • Trying to cut down or stop using the substance but being unable to
  • Experiencing intense cravings or urges to use the substance
  • Needing more of the substance to get the desired effect (tolerance)
  • Neglecting responsibilities at home, work, or school because of substance use
  • Developing withdrawal symptoms when not using the substance
  • Using substances in risky settings that put you in danger
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Licit drugs are

A

Legal drugs and available by prescription or sold OTC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Illicit drugs are

A

Illegal drugs including but not limited to phencyclidines (PCP, ketamine), hallucinogens (LSD, mescaline, MDA), stimulants (amphetamines, cocaine, crack), depressants (barbiturates, benzo’s) and opiates (heroin, morphine, methadone, codeine, fentanyl)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a dependence?

A
  • Results in tolerance, withdrawal, and compulsive substance taking behaviour
  • It is manifested by continuous use despite the presence of problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is physical dependence?

A
  • Occurs when an individual body reacts to the absence of a drug with withdrawal symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is psychological dependence?

A
  • Occurs when drug use becomes central to a person’s thoughts and emotions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is considered problematic substance use?

A
  • Can have severe and permanent consequences for individuals, families, and communities
  • Leads to adverse physical, psychological, legal, social, or interpersonal consequences, which may or may not involve dependence.
  • Can be episodic with periods of control and increased use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 4 C’s of addiction according to the CHMA?

A
  • CRAVING
  • Loss of CONTROL of amount or frequency of use
  • COMPULSION to use
  • CONTINUED substance use despite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why is there a spectrum for substance use?

A

People use substances for various reasons and in varying degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the spectrum of substance use?

A
  • Beneficial use; use that has positive health, social or spiritual effects i.e., coffee/tea to increase alertness
  • Casual/non-problematic use; recreational, casual, other use that has negligible health or social effects
  • Problematic use; use that begins to have negative consequences for individual, family/friends or society i.e., impaired driving, harmful routes of administration
  • Chronic dependence; use that has become habitual and compulsive despite negative health and social effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is meant by the word “Addict”?

A
  • Reduces someones identity to their struggle with substance use
  • Implies that there is no room for change, a condition of permanency
  • Carries the greatest stigma of all
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

True or False: Upon experimenting or using an addictive substance, the individual will immediately experience dependency or be “hooked”?

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is seen to be associated with problematic substance use?

A
  • IPV, child abuse, and sexual assault are associated with negative health effects including substance use and mental health challenges
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a concurrent disorder?

A
  • One or more co-occuring mental health challenges simultaneously with problematic substance use with the same person
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some intersecting relationships?

A
  • Violence, trauma, mental health and substance use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What should the CHN look at regarding the root causes of substance use and not overlap with mental health challenges?

A
  • Trauma, violence, social isolation, homelessness, and poverty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is chronic pain?

A
  • Complex, contextual and subjective
  • Stress of living in shelters, poor sleeping conditions, financial barriers to accessing over
    the counter medications all negatively impact the experiences of those with chronic pain
    who are homeless
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

A CHN’s pain management education should be?

A
  • Respectful of underlying beliefs
  • Must be evidence-based
  • In line with the lens of cultural safety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Problematic substance use is? Due to?

A
  • Multi-factorial
  • Familial, genetic, psychological, socioeconomic, and historical factors are all determinants of the problem
  • Gender, education, income and employment may also be factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

CHN’s need to use which perspective for developing comprehensive community health interventions that acknowledge ???

A
  • Socio-ecological perspective
  • Acknowledge the link between person, substance, and environment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are some factors related to the socio-ecological model for opioid use?

A
  • Age
  • Intimate partner violence
  • Policy
  • Unpleasant emotion
  • Withdrawal symptoms
  • Quality care
  • Current recession
  • Gender Race
  • Perceived neighbourhood violence
  • Unemployment
  • Family history of substance use
  • Drug disposal facilities
  • Nearest treatment facility >200km away
  • Mental health history
  • Social and cultural norms
  • Common use of opioids in public
  • Stress and trauma
  • Opioid access via friends and family
  • Law enforcement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

The Individual level of the Social-ecological framework + opioid crisis looks at?

A
  • age, race, gender, socio-demographic factors, stress and trauma exposure, physical and mental health, pain, withdrawal symptoms, self-stigma, self-determination, biological and genetic susceptibility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

The Relationships or Interpersonal level of the Social-ecological framework + opioid crisis looks at?

A
  • influence of family, friends, coworkers, opioid access via family, friends, coworkers, family history of substance use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

The Community level of the Social-ecological framework + opioid crisis looks at?

A
  • quality care, treatment availability + access, drug disposal facilities, community norms, workplace + school, geographic variations, access to legal and illegal opioids, over- prescription, types of rx opioids,
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

The Society level of the Social-ecological framework + opioid crisis looks at?

A
  • law enforcement & policing, educational campaigns, insurance coverage, government regulation & policies, economic conditions & employment rate, opioid supply and price, legal & illegal advertising, discrimination & prejudice, social stigma, media & social networks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are some health effects of tobacco use?

A
  • Smoking leads to disease and disability and harms nearly every organ of the body
  • Cancer
  • Heart disease
  • COPD
  • Fertility issues (affects men’s sperms)
  • Bone health
  • Cataracts (increases risk)
  • Type 2 Diabetes Mellitus (increased risk and harder to control)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are some short-term health effects of alcohol use?

A
  • Injuries (MVC, falls, drownings, burns)
    -Violence (homicide, suicide, sexual assault, intimate partner violence)
  • Alcohol poisoning
  • Risky sexual behaviours (unprotected sex, or sex with multiple partners which
    could result in unintended pregnancy or sexually transmitted diseases)
  • Miscarriage and still birth, or fetal alcohol spectrum disorders among pregnant women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are some long-term health effects of alcohol use?

A
  • High BP, heart disease, stroke, liver disease, digestive problems, pancreatitis
  • Cancer of the breast, mouth, throat, esophagus, larynx, liver, colon, and rectum
  • Weakened immune system
  • Learning and memory problems
  • Mental health problems including depression + anxiety
  • Social problems including family and job related problems
  • Alcohol use disorders or alcohol dependence
35
Q

What are the low-risk drinking guidelines?

A
  • Reduce your long-term health risks by drinking no more than:
    *10 drinks/week for women, with no more than 2 drinks a day “most days”
    *15 drinks/week for men, with no more than 3 drinks a day “most days”
    *Plan non-drinking days every week to avoid developing a habit
  • Special occasions:
    *Reduce your risk of injury/harm by drinking no more than 3 drinks (women) and 4 drinks (men) on any single occasion
  • Drinking tips:
  • Drink slowly, have no more than 2 drinks in 3 hours
    *For every drink of alcohol, have a non-alcoholic drink
    *Eat before and while you’re drinking
36
Q

What are some short-term health effects of cannabis use?

A
  • Decreased BP, which can increase risk of falls and syncope
  • Increased HR
  • Psychotic episodes (paranoia, delusions, hallucinations)
  • Confusion
  • Impaired ability to remember, concentrate and pay attention
37
Q

Using cannabis during pregnancy can lead to?

A
  • Lower birth weight of baby
  • Long-term development effects in children (decrease in memory, concentration, hyper-active behaviour, etc.)
38
Q

What are some long-term health effects of cannabis use?

A
  • Increased risk of dependency
  • Lung health (bronchitis, lung infections, chronic cough, increase mucous production)
  • Effects of the brain
  • Cannabis hyper-emesis syndrome (CHS) resulting in reoccurring nausea, vomiting, dehydration and abdominal pain
39
Q

Opioid reliance has _______ over-time along with opioid-related _________ and __________.

A
  • Increased
  • Morbidity and deaths
40
Q

The opioid crisis is a result of multiple factors, including?

A
  • Misunderstanding of the additive risks of prescription opioids
  • Psychological, social and biological risk factors
  • Stigma towards substance use disorders
  • Lack of awareness or access to alternative treatments for pain
  • Lack of access to prescription opioids leading to illicit opioid use
  • Use of prescription opioids to whom they are not prescribed
  • Illegal drugs that are laced with fentanyl and its analogues
41
Q

In 2022, there were approximately ____ deaths per day

A

21

42
Q

_____% of opioid deaths happen by accident

A

94%

43
Q

What are possible reasons for the opioid overdose of construction workers?

A
  • The physical demand of the job increase risk of injury and presence of chronic pain which contribute to opioid use
  • Mental health challenges associated with long hours, precarious, competitive, and repetitive tasks may also contribute
  • It may be more accessible for those to gain employment who already use substances compared to other sectors
44
Q

What are some factors related to opioid overdoes relating to street drugs..

A
  • Fake pills produced with unknown amounts of fentanyl
  • Some drugs contain fentanyl accidentally when made on the same surfaces
  • You cannot see, taste, or smell fentanyl
45
Q

Fentanyl is how many times stronger than _______?

A

100 times stronger than morphine

46
Q

One kg of fentanyl is enough to kill approximately how many people?

A

500,000 people

47
Q

What type of drug is Fentanyl and what are the indications of use?

A
  • A synthetic opioid analgesic
  • Pain management pre-operatively, general anesthesia, and analgesia
48
Q

What are the routes used for Fentanyl administration?

A
  • IM or IV in hospital, also available in transdermal patches
  • Intranasally for paediatrics
49
Q

What is the standard medical dosing of Fentanyl for adults?

A
  • IV: bolus 1-2 mcg/kg or 25-200 mcg/dose PRN
  • Continuous IV infusion: 25-200mcg/hr
  • IM: 50-100 mcg/dose IM q1-2hr PRN

1mg = 1000 mcg

50
Q
  • 69 y/o male, left shoulder dislocation post fall. Pre-shoulder relocation pain orders are the following: Fentanyl 50mcg IV 30 minutes prior to procedure
  • Dose on hand: Fentanyl 100mcg/2mL
  • How many mL of Fentanyl will the nurse administer?
A

0.05mg/0.1mg x2mL = 1mL

51
Q
  • 50 y/o female post operative bowel resection, currently on a ventilator requiring continuous analgesia. Weight 145lbs
  • Order: Fentanyl 0.7-2 mcg/kg/hr continuous IV infusion, maintain SBP >100
  • What is the minimum hourly this patient can receive?
  • What is the maximum hourly rate this patient can receive?
A
  • Minimum = 0.7mcg x 65.90kg = 46.13 mcg/kg/hr
  • Maximum = 2mcg x 65.90kg = 131.8 mcg/kg/hr
52
Q

What does Naloxone do and how quickly does it work? How long does it remain active?

A
  • Narcan temporarily reverses the effects of opioid overdoses within 2-5 minutes
  • Only remains active in the body for 20-90 minutes
53
Q

What opioids does Narcan work with?

A
  • Fentanyl, heroin, morphine, codeine
54
Q

What forms are Narcan (Naloxone) available in?

A
  • IM and intranasal formats
55
Q
  • 32 year old female with a respiratory rate of 3 and O2 saturations of 72% on 15L non-rebreather. They are a suspected heroin overdose. Please administer 0.1mg Narcan IV Q5 minutes until respiratory rate is 12
  • Dose available: 0.4mg/mL
  • How many mL will the nurse administer for the first dose?
A
  • 0.1mg / 0.4mg x1mL = 0.25mL
56
Q

What is the PHO: Interactive Opioid Tool used for?

A
  • Opioid related morbidity and mortality in Ontario
  • Looks at ER visits, hospitalizations and deaths
  • Can be viewed by public health unit, health integration network, age, sex, and in some cases drug type
57
Q

What does the term harm reduction refer to?

A
  • Policies, programs, and practices that aim to reduce the negative health, social and economic consequences that may ensue from the use of legal and illegal psychoactive drugs without reducing necessarily reducing drug use
  • Represents a continuum of services that embody a philosophical, pragmatic, and compassionate approach to providing care while minimizing the negative harms associated with substance use
58
Q

Harm reduction is an ___________ term that aims to reduce ???

A
  • Umbrella term
  • Negative consequences associated with behaviours that are typically considered high risk
59
Q

Harm reduction is ???

A
  • Goal-oriented
  • Humanistic
  • Non-judgemental and accepting of people with problematic substance use
  • Uses a person-centred approach
  • Underpinned by a commitment to change policy or is integrated into new policy
  • Healthcare providers “meet people where they’re at” and work collaboratively
60
Q

What is meant by housing first?

A
  • Provides clients with assistance in finding and obtaining safe, secure and permanent housing as quickly as possible
  • Housing that is not conditional on sobriety or abstinence
  • Is an evidence-based practice intended to serve chronically homeless individuals with co-occuring mental illness and substance use disorders
61
Q

What are the 5 core principles of the housing first approach?

A
  • Immediate access to housing with no readiness requirements
  • Consumer choice and self-determination (client choice in location, type)
  • Recovery orientation (access to a range of supports)
  • Individualized and client-driven supports
  • Social and community integration
62
Q

Supervised consumption sites provide??

A
  • A safe, clean space for people to bring their own drugs to use in the presence of trained staff
  • Prevents accidental overdose
  • Helps to reduce the spread of infectious diseases such as HIV
63
Q

What is the point of Needle Exchange Programs (NEP)?

A
  • Reduce transmission of HIV, Hep B, Hep C and other blood borne pathogens
  • Reduce the # of needles discarded in the community
64
Q

NEP provides which basic services?

A
  • Needle distribution and disposal
  • Condom distribution
  • Education and information
  • Referrals and counselling
65
Q

What other services do NEP programs provide?

A
  • Testing for HIV and STIs, Hep B + C and pregnancy
  • Offer immunizations, food and clothing banks, job referrals
  • Methadone maintenance clinical and medical care
  • Offers supplies like alcohol swabs, sterile filters/cookers/water, tourniquets, straight stems, bowl pipes, foil and paper straws
66
Q

What is Methadone? How long do the effects last?

A
  • An opioid medication used to create severe pain and opioid addiction, used for opioid agonist therapy and can be used in pregnancy
  • Long-acting and used to replace shorter-acting drugs like heroin and fentanyl
  • Effects typically last for 24-36 hours
  • If correct does is taken, it prevents withdrawal symptoms and reduces cravings
67
Q

What is Buprenorphine? How long do effects last?

A
  • Buprenorphine/naloxone combined, brand name is Suboxone and is used sublingually (SL)
  • Used to replace short-acting opioids, effects last 24-36 hours
  • Used to treat pain and opioid addiction
  • Lowers the potential for misuse and increases safety in cases of overdose
68
Q

What kind of education can the nurse provide regarding the basics of safe injections?

A
  • IV injections
  • How to safely choose a site
  • Veins vs. Arteries
  • Exercises for improving vein visibility
  • Cleaning your site
  • Inserting your needle
  • Missed shots + aftercare
69
Q

Education regarding the injection of cocaine:

A
  • Cocaine has a numbing effect on the vein and causes constriction so be extra careful that you are in the right spot before injecting; can be traumatic for the tissues
70
Q

Education regarding the injection of crack:

A
  • It comes in solid form, safest way to dissolve crack is with powdered citric or ascorbic acid
  • Avoid lemon juice or vinegar as they can cause infection
  • Only use what is needed as it is hard on the veins
71
Q

What are considered safe injection sites?

A
  • Arms and back of hands
72
Q

What are injection sites to avoid?

A
  • Legs, feet and breasts
73
Q

What are dangerous injection sites?

A
  • Wrists, neck, groin and penis
74
Q

What are some potential complications of IV drug use?

A
  • Abscess/skin infections
  • Scarring
  • Endocarditis
  • HIV/AIDS
75
Q

What is cellulitis and what is it caused by?

A
  • An infection that affects the skin and tissue underneath, causes pain and redness to area
  • Group A streptococcal bacteria common cause
  • Can progress to life-threatening necrotizing fasciitis and severe sepsis
76
Q

Symptoms and management of Cellulitis

A
  • Redness, swelling, warmth at site, possible fever
  • Assess site, trace borders, ultrasound for abscesses requiring surgical intervention, blood cultures, culture swabs when indicated and antibiotic therapy
77
Q

What is Infective Endocarditis caused by?

A
  • Injected material causes endothelial damage and is followed by infection from high bacterial loads
  • Caused by Staphylococcus aureus most commonly
78
Q

Symptoms/diagnosis/complications and management of Infective Endocarditis

A
  • S: Fever, chills, tachycardia, fatigue, persistent cough, aching joints, SOB, pallor, swelling in feet, legs and abdomen
  • D: Blood cultures, echocardiogram, ECG and CXR/CT
  • C: Severe sepsis, septic emboli involving lungs, kidney and brain, vegetation can grow on heart valves causing damage and failure
  • M: Antibiotic therapy up to 6 weeks or longer, and or heart valve replacement
79
Q

True or False: Invasive group A strep is a reportable communicable disease in Ontario?

A

True

80
Q

Primordial Prevention:

A
  • Nurses supporting public policy making that reduces structural inequities
    *Example: poverty is structural in that its related to economic policies, employment policies, discriminatory histories and systems, access to social services, and related factors
    *Reducing poverty could including implementing guaranteed annual income, employment supports geared to refugees, or an increase in child benefits
81
Q

Primary Prevention:

A
  • Involves preventing problematic substance use before it occurs with more focus on the individual or community rather than broader system
  • Includes activities geared towards preventing regular substance use from becoming problematic ie: the initiative that created Canada’s Low-Risk Alcohol Drinking Guidelines
  • Programs that prevent “ism’s” (racism, classism, sexism, ageism, ableism, colonialism) are protective against life experiences that put individuals, families, and communities at risk for problematic substance use
82
Q

Secondary Prevention:

A
  • Involve early identification of what substance use becomes problematic and rapid support to assist the individual in addressing root causes to reduce or end substance use
    *Example: screening, tools, or conversations that allow for the detection of signs and symptoms of problematic use ie the 11 criteria of substance use disorders
  • Can occur on an inpatient or outpatient basis, be supported privately or publicly and involve a wide variety of tools
    *May involve individual or group counselling with a focus on moving the individual from problematic use to recovery
83
Q

Tertiary Prevention:

A
  • Reducing harms of problematic use both for individuals and their families + communities
  • Treatment can be included as a form of tertiary prevention as well as secondary
  • Other examples: clean needles, pop-up supervised consumption sites, managed alcohol programs, naloxone distribution programs

3007 Final (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions