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NURS783 Exam 4 > Substance Use > Flashcards

Substance Use Flashcards

1
Q

What risks are associated w/ intranasal and IV drug use?

A
  • HBV
  • HCV
  • HIV
  • DVT
  • thrombophlebitis
  • endocarditis
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2
Q

What factors of substance use affect the fetus?

A

1) type of substance
2) timing of use during embyrogenesis and fetal development
3) duration and amount of substance

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3
Q

caffeine

A
  • no evidence of teratogenicity

- may decrease Fe absorption –> anemia

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4
Q

What are risks associated w/ alcohol in early pregnancy?

A
  • miscarriage
  • embryopathy
  • visible physical defects
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5
Q

What are risks associated w/ alcohol in later pregnancy?

A
  • developmental disabilities
  • cognitive disabilities
  • behavioral disabilities
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6
Q

What demographic has the highest rate of late trimester alcohol consumption?

A

white, college-educated women >35yo

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7
Q

Describe fetal alcohol syndrome

A

most severe of fetal alcohol spectrum disorders

  • growth deficiency
  • CNS dysfunction w/ developmental disability/brain damage
  • characteristic facial dysmorphology
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8
Q

List 3 fetal alcohol spectrum disorders

A

1) fetal alcohol syndrome
2) partial fetal alcohol syndrome
3) alcohol-related birth defects

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9
Q

What are pregnancy risks associated w/ nicotine use?

A
  • reduced fertility
  • increased risk ectopic
  • SAB
  • reduced infant response to hypoxic events
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10
Q

What effect does nicotine have on placenta?

A

vasoconstriction –> compromised function

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11
Q

What demographic of people are more likely to smoke during pregnancy?

A
  • <25yo
  • unmarried
  • Caucasian
  • <12 years education
  • low-income
  • underweight
  • unintended pregnancy
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12
Q

What neonatal risks are associated w/ nicotine use?

A
  • cleft lip/palate
  • musculoskeletal effects
  • GI defects
  • asthma
  • atopic diseases
  • otitis media
  • SIDS
  • neuro developmental delay
  • reduced head circumference
  • altered brain stem development
  • altered lung structure
  • cerebral palsy
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13
Q

What risks are associated w/ marijuana use?

A
  • congenital defects
  • neurobehavioral changes
  • +/- childhood leukemia
  • IUGR, small head circumference
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14
Q

What are risks associated w/ opiate use?

A
  • IUGR
  • placental insufficiency
  • preeclampsia
  • PROM
  • PTB
  • perinatal mortality
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15
Q

What effect does opiate use have on the neonate?

A

neonatal abstinence syndrome –> prolonged hospitalization

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16
Q

What are effects of acute opioid withdrawal?

A
  • tachycardia
  • HTN
  • GI distress
  • increased risk fetal mortality

medication-assisted tx recommended

17
Q

Describe management w/ methadone

A
  • full agonist w/ long 1/2 life
  • dispensed in federally licensed tx centers
  • pregnant people often require higher doses that should be split into 2
18
Q

Describe management w/ buprenorphine

A
  • partial agonist
  • not FDA approved for tx of opioid dependence in pregnancy
  • can be accessed in office visit
  • often require higher doses in pregnancy
19
Q

List 3 validated screening instruments

A

1) T-ACE
2) TWEAK
3) AUDIT C

20
Q

T-ACE

A

Tolerance
Annoyed
Cut down
Eye opener

score 2+ = positive screen

21
Q

TWEAK

A 
Tolerance
Worry from family in past year
Eye opener
Amnesia 
K(C)ut down
22
Q

AUDIT-C

A

1) How often to you have a drink containing alcohol?
2) How many drinks containing alcohol do you have on a typical day?
3) How often do you have 6+ drinks in one occasion?

3+ = positive

23
Q

What are the 5 As of smoking cessation?

A

1) Ask about smoking
2) Advise to stop
3) Assess willingness to quit
4) Assist by providing resources
5) Arrange f/u

24
Q

What are the 5 Rs of smoking cessation?

A

1) Relevance
2) Risks
3) Rewards
4) Roadblocks
5) Repetition

25
Q

What pharmacological management can be used for smoking cessation?

A

1) bupropion (Wellbutrin): low risk in pregnancy
2) varenicline (Chantix): research pending

No evidence of teratogenicity
Risk of psych sx

26
Q

When is the classic teratogenic period?

A

31-71 days after LMP

most structural defects occur during 2nd-8th wks after conception (embryonic period)

27
Q

List known teratogenic rx

A

1) antiepileptics (i.e. valproic acid)
2) isotretinoin
3) tetracycline –> teeth discoloration
4) aminoglycosides –> ototoxic
5) ACEs and ARBs –> renal failure

28
Q

What are the risks associated w/ lead?

A
  • SGA infant
  • PTB
  • lead poisoning
29
Q

What are the risks associated w/ ionizing radiation?

A
  • microcephaly
  • cognitive disabilities
  • growth restriction
30
Q

What are the risks associated w/ fish mercury?

A

harmful to developing nervous system

31
Q

What are resources for teratogen exposure?

A

1) LactMed
2) TOXNET
3) Reprotox
4) TERIS

NURS783 Exam 4 (11 decks)

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