Test 2: Blueprint (5) Flashcards
What is considered legally intoxicated?
Blood alcohol content of 0.08% (80 g/dl)
What level of intoxication could result in death?
greater than 0.35% (350 g/dl)
Alcohol intoxication occurs at BAC between ___ - ___ mg/dl.
100 - 200 mg/dl
What screening method can be used to assess someone dealing with alcohol abuse?
CAGE questionaire
What does CAGE stand for?
Cut
Annoyed
Guilty
Eye-opener
CAGE: What is “Cut”?
Have youever felt you should CUT down on your drinking?
CAGE: What is “Annoyed”?
Have people ANNOYED you by criticizing your drinking?
CAGE: What is “Guilty”?
Have you ever felt bad or GUILTY about your drinking?
CAGE: What is “Eye-opener”?
Have you ever had a drink first thing in the morning to steady your nerves?
What must a nurse do before working with a person with alcohol dependency?
examine own attitudes and person experiences with substances
What is it called with someone is suffering from 2 completely separate mental health issues?
dual diagnosis
What can be done for the client during detoxification?
- provide safe and supportive environment
- administer substitution therapy
What is done during intermediate care?
- provide explanations of physical symptoms
- promote understanding and identify causes of substance dependency
- help client accept use of substance as a problem
- provide education and assistance to client and family
What is done during evaluation?
involves reassessment to determine whether the nursing interventions have been effective in achieving the intended goals of care
How long after last drink will withdrawal occur?
within 4 to 12 hours of cessation or reduction in heavy or prolonged alcohol use
List symptoms of withdrawal:
- coarse tremor of hands
- tongue or eyelids
- sweating
- elevated blood pressure
- anxiety
- depressed mood or irritability
- transient hallucinations or illusions
- headache and insomnia
- D.T.s
What are 4 nursing considerations for withdrawal?
1) safety
2) vital signs q4h or PRN
3) admin ordered meds
4) seizure precautions
What meds are commonly used for withdrawal?
- antabuse (Disulfram - abstinance drug…remember it makes you feel like your going to die)
- benzos
- tegretol
- thiamine
What groups are for recovering alcoholics? for families of alcoholics?
AA- alcoholics
Al-Anon - families
What is defined as dysfunctional behaviors by friends/families that protect/enable dependency (ie, keeping secrets or protecting)
co-dependency
Co-dependent people ___ their own ___ for the fulfillment of others to achieve a sense of ___.
sacrifice
needs
control
T/F: Co-dependent people often releases anxiety in the form of stress-related illnesses or compulsive behaviors like eating, spending, working or their own substance abuse.
True
T/F: Co-dependent people are comfortable directing their own lives.
False!
They are outwardly focused on others and know very little about how to direct their lives from their own sense of self.
What is the main defense mechanism of alcoholism?
Denial
Rationalization is also used
12 complications of long-term alcohol abuse:
1) cirrhosis of the liver
2) portal hypertension
3) ascites
4) esophageal varices
5) Korsakoff’s psychosis
6) Wernicke’s encephalopathy
7) Peripheral neuropathy
8) Esophagitis
9) Gastritis
10) Pancreatitis
11) Hepatic encephalopathy
12) Alcoholic cardiomyopathy
Signs of cirrhosis of the liver:
(Think...HEPA) Hepatic encephalopathy Esophageal varices Portal hypertension Ascites
What causes cirrhosis of the liver?
overworking the liver
What is cirrhosis of the liver?
- formation of nodules of regenerating liver cells
- replaced with connective tissue (fibrosis)
What is elevation of BP through the portal circulation resulting from defective blood flow through damaged liver?
portal hypertension
What is ascites?
excessive amount of serous fluid accumulates in the abdominal cavity.
occurs in response to portal hypertension
What occurs when veins in the esophagus become distended b/c of excessive pressure from defective blood flow through the cirrhotic liver.
esophageal varices
What is Korsakoff’s psychosis?
a syndrome of confusion, loss of recent memory and confabulation in alcoholics
What patients often suffer from Korsakoff’s psychosis?
pts recovering from Wernicke’s encephalopathy
Wernicke-Korsakoff Syndrome
What is the most serious form of thiamine deficiency in alcoholics?
Wernicke’s encephalopathy
What are the signs/symptoms of Wernicke’s encephalopathy?
- paralysis of the ocular muscles - diplopia
- ataxia
- somnolence
- stupor
What will occur if thiamine is not replaced quickly?
death
What is seen with peripheral neuropathy?
peripheral nerve damage resulting in pain, burning, tingling, or prickly sensations of the extremities
What deficiency causes peripheral neuropathy?
vitamin B (thiamine) Remember..."My feet B tingling."
Is peripheral neuropathy reversible or irreversible?
reversible with abstinence from alcohol and restoration of nutritional deficiencies
What is esophagitis and what causes it?
- inflammation and pain in the esophagus
- occurs b/c of the toxic effects of alcohol on the esophageal mucosa
What occurs due to frequent vomiting associated with alcohol abuse?
esophagitis
What is gastritis?
inflammation of the stomach lining
What is seen with gastritis?
epigastric distress
N/V
distension
What happens with gastritis?
alcohol breaks down the stomach’s protective mucosal barrier allowing HCl to erode the stomach wall
What is pancreatitis?
inflammation of pancreas
Is pancreatitis acute or chronic?
it can be either
Acute or chronic pancreatitis? Occurs 1-2 days after an alcohol binge.
Symptoms are severe epigastric pain, N/V, abdominal distention
Acute pancreatitis
Acute or chronic pancreatitis?
Leads to pancreatic insufficiency resulting in steatorrhea, malnutrition, weight loss, and DM
Chronic pancreatitis
When does hepatic encephalopathy occur?
In response to the inability of the diseased liver to convert ammonia to urea for excretion
What happens if the serum ammonia is allowed to progress with hepatic encephalopathy?
coma and death
Alcohol negatively affects the heart by lipid accumulation in the myocardial cells, resulting in enlargement and a weakned condition. What does this lead to?
Alcoholic cardiomyopathy
What does alcoholic cardiomyopathy generally relate to?
CHF or arrhythmia
What are symptoms of alcoholic cardiomyopathy?
- decreased exercise tolerance
- tachycardia/palpitations
- dyspnea
- edema
- nonproductive cough
What will labs show with alcohol cardiomyopathy?
elevated enzymes CPK, AST, alanine, aminotransferase (ALT), and LDH
What tests can be done to diagnose alcoholic cardiomyopathy?
ECG
X-ray may show CHF
Is cardiomyopathy treatable?
No, can only be treated with a heart transplant
