Substance Use Disorder Flashcards
sustained moderation is most difficult with these substances
smoking, alcohol, opiods
most important question during an assessment of substance abuse
when did you last use?
why is it important to know when someone last used, particularly with alcohol
determines when you can expect withdraw symptoms
alcohol = 24-48 hrs. post use
initial assessment/screen questions (2)
In past year, have you ever drank or used drugs more than you meant to?
Have you felt you wanted to cut down on drinking or drug use in past year?
CAGE AID screening tool questions
C: Have you ever felt the need to cut down?
A: Have people annoyed you by criticizing your use?
G: Have you ever felt guilty about use?
E: Have you ever felt need for an eye opener in morning?
2 neuropsychiatric syndromes r/t alcohol
wernicke’s - confusion
korsikoff’s syndrome - memory loss - permanent
to reverse s/s of wernicke’s
vitamin b - thiamine
is korsikoffs syndrome reversible
no
to determine drug use type/amount
urine toxicology or blood alcohol level
defense mechanisms r/t substance use disorders
denial - I can stop whenever I want
projection - blame behaviors on someone else
rationalization - I’m more effective when i drink
all or none thinking - can’t stop once you start drinking
alcohol withdraw s/s
autonomic hyperactive response - increased VS, bilateral hand tremors
primary treatment for alcohol withdraw
benzo
alcohol delirium s/s
altered LOC
Mr. Stewart’s blood alcohol level (BAL) is 0.31%. Even though he has a BAL of 0.31%, Mr. Stewart is alert and oriented, not slurring his speech or giving any other outward signs of intoxication. The difference between Mr. Stewart’s BAL and his behavior indicates the development of what symptom of physical dependence?
tolerance - needs more of a substance to illicit same reaction
normal alcohol level
.08
trt approach for alcohol withdraw
sedate pt. for calmness
trt approach for seizures r/t alcohol withdraw
dilantin - anticonvulsants
drugs used to maintain abstinence
antibuse - if pt. drinks they become very ill
relapse is part of recovery, t or f
true
Jessie is attending AA meetings three times a week for the past 6 weeks. She has been sober during this time and visits bi-weekly the community mental health outpatient clinic. Jessie’s nurse counselor wants to talk with her about the AA meetings. Which initial question or statement is most appropriate?
D.“Tell me about the last AA meeting you attended.”
most therapeutic approach you can have for substance abusers
empathy and support with firmness. confront abusers
Jessie has missed three sessions at the mental health center and sporadically attends AA meetings. She is drinking heavily this weekend and has sustained a 2
-inch gash in her forehead after swerving off the road into a shallow ditch. She is taken by rescue to the ED. You are her nurse. She tells you, “I hope I just go to
sleep and never wake up.” What is your best intervention?
D. Stay with Jessie, call the supervisor, and arrange for
continuous monitoring.
During the third week of treatment, the spouse of a patient in an alcoholism rehabilitation program says, “After discharge, I’m sure everything will be just fine.” Which remark by the nurse will be most helpful to the spouse?
B.“Although sobriety solves some problems, new ones
may emerge as one adjusts to living without alcohol.”
why keep things simple in the beginning of treatment plans
pt is sick - when feeling better gradually incorporate insight therapy and CBT - teach damage to body systems
SMART therapies alternative to 12 step programs
science based recovery - being accountable without spiritual component
A patient comes to an outpatient appointment obviously intoxicated. The nurse should:
D.tell the patient, “We cannot see you today because
you’ve been drinking.”
Select the most appropriate outcome for a patient completing the fourth alcohol detoxification program in 1 year. Before discharge, the patient will
B. I see the need for ongoing treatment
A nurse can assist a patient and family in which aspects of substance abuse relapse prevention? Select all that apply.
A.Rehearsing techniques to handle anticipated stressful
situations
C.Assisting the patient to identify life skills needed for
effective coping
E.Teaching the patient about the physical changes to
expect as the body adapts to functioning without substances
