T2 - Substance-Related & Addictive Disorders (Josh) Flashcards
Addiction is a — — disorder
Substance-Use Disorder
Mr. White has been admitted after binge drinking. His wife reports that he has been a heavy drinker for a # of yrs. Lab reports reveal he has a blood alcohol level of 250 mg/dL. He is placed on chemical addiction unit for detox. When would the first signs of alcohol withdrawal symptoms be expected?
a) several hrs after last drink
b) 2-3 days after last drink
c) 4-5 days after last drink
d) 6-7 days after last drink
a) several hrs after last drink
- 4-12 hrs
If operating an automobile, what is considered intoxication?
What is normally considered intoxication?
80 g/dL (0.08%)
100-200 mg/dL
Intoxication is – — disorder
Substance-Induced Disorder
Drugs for ETOH Withdrawal (ATI)
Diazepam
Lorazepam
Carbamazepine
Clonidine
Chlordiazepoxide
A nurse is providing teaching to the family of a client who has a substance use disorder. Which of the following statements by a family member indicates need for further teaching?
a) We need to understand that she is not responsible for her disorder
b) Eliminating any codependent behavior will promote recovery
c) She should participate in an Al-anon group to help her recover
d) The primary goal of her treatment is abstinence from substance use
c) She should participate in an Al-anon group to help her recover
- Al-anon is for the family, not the client
- AA is for the client
Signs of Opioid Withdrawal
dysphoric mood
n/v
muscle aches
lacrimation or rhinorrhea
pupil dilation
piloerection
sweating
diarrhea
yawning
fever
insomnia
What is the most common ego defense mechanism used by alcoholics?
denial
A nurse is caring for a client who has ETOH use disorder. The client is no longer experiencing withdrawal manifestations. Which of the following meds should the nurse anticipate administering to assist the client w/ maintaining abstinence?
a) Chlordiazepoxide
b) Buproprion
c) Disulfrium
d) Carbamazepine
c) Disulfrium
Alcohol intoxication occurs at
100-200 mg/dL
What are some complications from cirrhosis of the liver?
Portal HTN
Ascites
Esophageal Varices
Hepatic Encephalopathy
Withdrawal is a — — disorder
Substance-Induced Disorder
When could ETOH Withdrawal Delirium occur?
2-3 days after cessation
lasts for 2-3 days
it is a medical emergency
Dan, who has been admitted to the ETOH rehab unit after being fired for drinking on the job states to the nurse, ‘I don’t have a problem w/ ETOH. I can handle booze better than anyone I know. My boss is a jerk! I haven’t missed more days than my coworkers.’
The nurses best response is..
a) Maybe your boss is mistaken
b) You’re here b/c your drinking was inerferring w/ your work
c) Get real! Youre a boozer and you know it!
d) Why do you think your boss sent you here?
b) You’re here b/c your drinking was inerferring w/ your work
Features of Fetal Alcohol Syndrome (FAS)
small eye opening
small head circumference
skin folds at corner of ey
small midface
short nose
thin upper lip
indistinct groove b/t lip
Complicated ETOH withdrawal can progress to –
Alcohol Withdrawal Delirium
Alcohol withdrawal occurs within — of cessation/reduction in ETOH.
4-12 hours
– is identified by confusion, loss of recent memory, and confabulation in alcoholics.
Korsakof’s Psychosis
Is Opioid withdrawal life-threatening?
Not usually, but it IS unpleasant
self-limiting to 7-10 days
Which of the following meds is the physician most likely to order for a client experiencing ETOH withdrawal?
a) Haloperidol
b) Chlordiazepoxide
c) Methadone
d) Phenytoin
b) Chlordiazepoxide
Drugs for ETOH Abstinence (ATI)
Disulfrium
Naltrexone
Acamprosate
What is the most serious form of thiamine deficiency in alcoholics?
Wernicke’s Encephalopathy
A nurse is planning a staff education program on substance use in older adults. Which of the following is appropriate for the nurse to include?
a) Older adults require higher doses of a substance to achieve its desired effect
b) Older adults commonly use rationalization to cope w/ a substance use disorder
c) Older adults are at a higher risk for substance use following retirement
d) Older adults develop substance use to mask signs of dementia
c) Older adults are at a higher risk for substance use following retirement
Drugs for Opioid Withdrawal (ATI)
Methadone
Clonidine
Buprenorphine
How long do ETOH withdrawal symptoms last?
start 4-12 hrs and peak after 24-48 hrs, then suddenly disappear
A nurse is assessing a client who has ETOH use disorder and is experience withdrawal. Which of the following is an expected finding? (SATA)
a) Bradycardia
b) Fine tremors in both hands
c) Hypotension
d) Vomiting
e) Restlessness
b) Fine tremors in both hands
d) Vomiting
e) Restlessness
Dan has been admitted to the ETOh rehab unit. Dan’s drinking buddies come for a visit, and when they leave, the nurse smells ETOH on Dan’s breath. Which is the best intervention w/ Dan at this time?
a) Search his room
b) Ask, ‘Have you been drinking Dan?’
c) Send a urine specimen to the lab for drug screening
d) Tell Dan, ‘These guys cannot come to the unit to visit you again’
c) Send a urine specimen to the lab for drug screening
Symptoms of ETOH withdrawal include:
a) euphoria, hyperactivity, and insomnia
b) depression, suicidal ideation, and hypersomnia
c) diaphoresis, n/v, and tremors
d) unsteady gait, nystagmus, and profound disorientation
c) diaphoresis, n/v, and tremors
A nurse is planning care for a client who is experiencing Benzo withdrawal. Which of the following is the priority intervention?
a) Orient the client frequently to time, place and person
b) Offer fluids and nourishing diet as tolerated
c) Implement seizure precautions
d) Encourage participation in group therapy sessions
c) Implement seizure precautions
