TOPIC 11 - substance abuse and addictive disorders (pt 2) Flashcards
mandating for reporting substance abuse
reporting an impaired colleague is a peer responsibility
clean documentation is crucial and mandatory
who’s responsibility if intervention of substance abuse
nurse manager and administrators
If an impaired nurse remains in the practice situation and no action is taken by the nurse manager, the information must be taken to the next level in the chain of command
benefits of reporting an impaired colleague
improve safety of patients
protect healthcare professionals future ability to practice
improved physical health
improved or saved personal relationships
may save professional care
ten classes of psychoactive substances
- alcohol
- caffeine
- marijuana
- hallucinogens
- inhalants
- opioids
- sedatives
- hypnotics
- anxiolytics
- stimulants, tobacco, and other substances
marijuana
most commonly used illicit drug in the USA
nicotine addiction rates
addiction is high in all groups of people with substance dependence as well as those with psychiatric mental health issues
examples of CNS depressants
barbiturates
benzos
alcohol
intoxication symptoms of CNS depressants
Slurred speech
Incoordination
Unsteady gait
Drowsiness
Hypotension
Sexual or aggressive disinhibition
Impaired judgement
Impaired social or occupational function
Impaired attention or memory
CNS depressants overdose symptoms
Cardiovascular or respiratory depression, coma, shock, convulsions, death
CNS depressants overdose treatment
If awake, keep awake *
Induce vomiting
Administer activated charcoal (absorption of drug)
Check vitals every 15 minutes
CNS depressants coma interventions
Clear airway, insert endotracheal tube
Administer IV fluids
Gastric lavage with activated charcoal
Frequent vital sign checks continue after patient is stable (potential remains for shock and cardiac arrest)
Implement seizure precautions
Hemodialysis may be needed
Administer flumazenil (Romazicon) IV for benzodiazepine overdose
benzo antidote
flumazenil
examples of opiates
Morphine
Heroin
Codeine
Fentanyl
Methadone
Meperidine
opiate intoxication effects
Constricted pupils *
Decreased respiration
Decreased blood pressure
Slurred speech
Drowsiness
Psychomotor retardation
Initial: euphoria
Later: dysphoria
Impaired: concentration, judgment, memory
opiate withdrawl effects
Yawning
Insomnia
Irritability
Rhinorrhea
Panic
Diaphoresis
Cramps
Nausea and vomiting
Muscle aches
Chills and fever
Lacrimation
Diarrhea
pregnancy and heroin
do not abruptly stop use
opiates overdose effects triad symptoms
coma, pinpoint pupils, respiratory depression
other overdose effects of opiates
Cardiac arrest
Shock
Convulsions
Death
opiate overdose treatment
naloxone
important parts to naloxone
Quickly reverses CNS depression caused by opioid drugs
Short half-life
May need to repeat dose
examples of long term pharmacologic management of opioid use disorders
methadone, buprenorphin, maltrexone, clonidine
methadone
Opioid agonist that blocks the craving for opioids
Also used for detoxification
Most effective
which is the most effective long term management of opioid use disorder
methadone
buprenorphin
Opioid agonist-antagonist
Blocks the signs and symptoms of opioid withdrawal
naltrexone
Opioid antagonist that blocks the euphoric effects of opioids.
what combination with clonidine is effective
with naltrexone
examples of CNS stimulants
Cocaine & crack
Methamphetamine
Caffeine
Nicotine
intoxication effects of CNS stimulants
Dilation of the pupils*
Dryness of the oronasal cavity
Excessive motor activity
Dilated pupils
Tachycardia
Increased blood pressure
Nausea & vomiting
Insomnia
withdrawl effects of CNS stimulants
Depression
Paranoia
Anxiety *
Lethargy
Insomnia
Nausea
Vomiting
Sweating
Chills
Fatigue
Agitation
Apathy
Disorientation
Lethargy
Craving
Sleepiness
overdose effects of CNS stimulants
Respiratory distress
Hyperpyrexia
Convulsions
Coma
Stroke
MI
Death