Substance Use Disorder

Question 1

what is addiction

Answer 1

a brain disease that evolves as a result of drug/alcohol use, sexting, gambling, and overeating

Question 2

difference between substance abuse and dependence

Answer 2

abuse - use outside of social acceptance/medical necessity - adverse effects to self/others
dependence - tolerance - higher dose to illicit same response - control lost - can be fatal

Question 3

how does addiction happen

Answer 3

voluntary to compulsive use of a substance

reward circuit is activated (dopamine is released)

Question 4

what stimulates the reward center leading to addiction

Answer 4

dopamine (responsible for pleasure/pain) - 1st time than can no longer stimulate reward center - addicts seek the dopamine release causing the addiction

Question 5

special populations r/t substance use/abuse

Answer 5

nurses and pregnant women (should be screened)

Question 6

most common used and abused substance

Answer 6

alcohol

Question 7

moderate vs excessive use of alcohol

Answer 7

moderate - 2 glasses for men, 1 for women

excessive - creates problems for all organs, systems

Question 8

***effects of alcohol on the body

Answer 8

depresses CNS function
enhances GABA inhibition
activates the reward circuit (regulated by dopamine)

Question 9

2 chronic neuropsychiatric symptoms of alcohol

Answer 9

wernicke’s encephalopathy

korsakoff’s psychosis

Question 10

s/s of wernicke’s encephalopathy

Answer 10

confusion, abnormal ocular movements caused by thiamine deficiency (diet or alcohol induced suppression of thiamine/b vitamin)

Question 11

how is wernickes reversed

Answer 11

vitamin B

Question 12

how is korsakoff’s psychosis reversed

Answer 12

it can not be reversed

Question 13

effects of korsakoff’s psychosis

Answer 13

inability to convert short term memory into long term memory

Question 14

chronic effects have a significant impact on cognition function over time, t or f

Answer 14

true - difficulty with memory and problem solving - deteriorates the neurons over time - interferes w/REM sleeping

Question 15

appearance of alcohol intoxication

Answer 15

slurred speech, uncoordinated, impaired judgement

Question 16

**s/s of alcohol withdraw

Answer 16

irritable, shaky, tremulous, may have seizures, increase in vital signs

Question 17

**if withdraw for alcohol (CNS depressants) is not addressed what can happen

Answer 17

alcohol withdraw delirium

Question 18

difference with withdraw and delirium

Answer 18

withdraw - shaky - delusions - hallucinations

delirium - change in LOC (in and out) - tactile (bugs crawling on the them)

Question 19

treatment for delirium

Answer 19

IV Librium - haldol

to prevent seizures - dilantin

Question 20

if trt is not followed for delirium what can occur

Answer 20

death can occur

Question 21

CNS stimulants examples

Answer 21

caffeine, nicotine, crack cocaine

Question 22

s/s of stimulant abuse

Answer 22

dilation of pupils
excessive motor activity
dry oronasal cavity

Question 23

s/s of cocaine/crack intoxication

Answer 23

euphoric, impaired judgment, aggressive
increased HR, sweating, chills
pupils are dilated, hyperactive state

Question 24

overdose of cocaine/crack can result in

Answer 24

MI, stroke, coma, or death

Question 25

s/s of withdraw from cocaine/crack

Answer 25

depressed mood, insomnia, craving cocaine

Question 26

drug of choice for alcohol withdraw

Answer 26

benzos

Question 27

trt for cocaine/crack withdraw

Answer 27

nothing

Question 28

**if withdrawing from an CNS stimulant closely monitor pt. for this

Answer 28

suicidal risk - effects neurotransmitters - rebound depression can occur

Question 29

s/s of methamphetamine use

Answer 29

euphoria, aroused, “can accomplish anything” a lot of strength - mimics a psychotic state (hallucinations)

Question 30

*do methamphetamine’s cause a physical or psychological dependence

Answer 30

psychological

Question 31

s/s of methamphetamine withdraw

Answer 31

dysphoria, strong craving of the drug

Question 32

most common effect of smoking

Answer 32

cardiovascular disease

Question 33

largest preventable cause of premature death is from smoking, t or f

Answer 33

true

Question 34

intoxication vs withdraw effects of opiods

Answer 34

intoxication - constricted pupils, decreased VS, decreased respiration’s, euphoric effect
withdraw - rarely fatal, n/v/d, anxious

Question 35

opiod of choice, most common street drug

Answer 35

heroin - Oxycontin growing in prevalence

Question 36

opiod overdose s/s

Answer 36

triad - resp. depression, coma, pinpoint pupils

Question 37

agent used to reverse opiod overdose

Answer 37

narcan

Question 38

effects of heroin

Answer 38

euphoria, lower abd. sensation similar to orgasm, n/v

Question 39

opiod similar to morphine

Answer 39

oxycodone

Question 40

drug most commonly abused by nurses and doctors

Answer 40

meperidine (taken orally)

Question 41

oxycodone has a physical or psychological dependence

Answer 41

both a physical and psychological dependence

Question 42

how is oxycodone used

Answer 42

crushed and snorted

Question 43

Jessie had a blood alcohol level (BAL) of 0.11% upon arrival at the emergency department (ED). She is now your patient in the hospital psychiatric unit, day 4. She tells you, “ I wasn’t drunk. I just had a few beers.” What is an appropriate response?

Answer 43

2. “Jessie, your BAL was 0.11%. That clearly indicates

that you had alcohol intoxication.”

Question 44

A patient comes to an outpatient appointment obviously intoxicated. The nurse should:

Answer 44

D. tell the patient, “We cannot see you today because

you’ve been drinking.

Question 45

Which nursing diagnosis would likely apply to both patients with paranoid schizophrenia and patients with amphetamine-induced psychosis?

Answer 45

B.Disturbed thought processes

Question 46

A patient has smoked two packs of cigarettes daily for many years. When the patient does not smoke or tries to cut back, anxiety, craving, poor concentration, and headache result. What does this scenario describe?

Answer 46

C.Substance dependence