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Psych > unit 3 test substance abuse > Flashcards

unit 3 test substance abuse Flashcards

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1
Q

incentive salience

A

when a person is presented w a stimulus from an addicitve drug, they will experience overwhelming desire to use the drug again

  • CNS affected
  • leads to high rate of relapse
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2
Q

psychological dependance

A

believes sub needed to function optimally

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3
Q

withdrawl concepts-4

A
  • substance specific
  • sym not due to med do
  • early recognition is critical
  • delerium seen if w/d not treated properly
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4
Q

4 key concepts of addiction

A
  1. denial
  2. rationalization
  3. minimization of consequences
  4. projection-lays blame outside self
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5
Q

CNS depressants-4

A
  1. alcohol
  2. sedative/hypnotic and anxiolytic
  3. club/date rape drugs
  4. opiates/opioids
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6
Q

4 phases of alcohol abuse

A
  1. pre-alcoholic- needs to cope, develops tolerance
  2. early alcoholic- blackouts/ETOH required/preoccupation w drinking begins
  3. crucial phase- control lost, physiological dependance
  4. chronic- physical and emotional disintegration, can lead to death
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7
Q

wernicke encephalopathy (alcohol)-5

A
  • delirium w cranial nerve dysfunction
  • thiamine deficiency
  • life threatening w/o thiamine replacement
  • “Acute confusion” RN diagnoses
  • impaired speech, cognition, orientation, and arousal
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8
Q

korsakoffs delirium

A

delirium w profound loss of recent memory, confusion, and confabulation
-treat w thimine replacement

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9
Q

alcohol intoxication char-8

A

labile mood, impaired judgement, impaired social and occupational funct, slurred speech, incoordination, unsteady gait, nystagmus, flushed face

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10
Q

alcohol w/d-4

A
  • symptoms occur 4-12 hrs after last drink
  • DTs 5-7 days after
  • symptoms peak 24-28 hrs
  • risk for seizure give MgSO4
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11
Q

delirium tremens (DT)-9

A
  • onset 2-3 days after last drink, peak after 2-3 days
  • vivid hallucinations, confusion and disorientation, agitation, autonomic hyperactivity (hyperthermia, HTN, tachycardia, diaphoresis->can lead to death)
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12
Q

Alcohol w/d interventions-5

A
  1. decrease environmental stim (low light for illusions)
  2. fluids- PO or IV
  3. ativan or librium protocol
  4. MgSO4- seizures
  5. nutritional supplements- multivitamin (b-complex for neuropathies), folic acid, thiamine
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13
Q

sedative/hypnotics include 2 drug types

A
  1. barbituates-seconal (secobarbital), amytal (amobarbital)

2. non-barbituates- chloral hydrate, zolpidem (ambien)

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14
Q

anxiolytic/benzodiazepines-3 drugs

A

alprazolam (xanax), chlordiazepoxide (librium), lorazepam (ativan)

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15
Q

perscription drug patters-2

A
  1. prescribed by dr-tolerance, dr shop

2. recreational use illegally

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16
Q

club and date rape drugs-2 kinds

A
  1. gamma hydroxybutyric acid (GHB)

2. flunitrazepam (rohypnol)

17
Q

sedative/hypnotic/anxiolytic/date rape intox symptoms-7,6

A
  • ataxia, slurred speech, drowsiness/sedation, N/V, resp depression, decreased LOC
  • disorientation, labile mood, disinhibited aggressive or sexual drives, impaired judgement/social funct/attention/memory, irritability
18
Q

sedative/hypnotic w/d symptoms-6

A
  • autonomic hyperactivity-elevated vitals, sweating, tremors, anxiety, N/V, insomnia
  • delirium 4-7 days
19
Q

sedative w/d interventions-5

A

decrease environmental stimuli,

seizure precautions, administer benzos or barbituates, fluids, abrupt w/d can lead to death

20
Q

pseudo addiction

A

symptoms develop from inadequate pain mgt

21
Q

opiate intoxication symptoms-3

A
  1. initial euphoria
  2. apathy, dysphoria, and impaired judgement
  3. slurred speech, impaired memory, constricted pupils
22
Q

opiate overdose symptoms-3

A

dilated pupils, depressed resp, change in LOC

  • can lead to coma, seizures, death
  • assess for suicide if intentional
23
Q

opiate w/d symptoms-9

A
  • sweating, rhinorrhea, piloerection, tremors, irritability
  • severe weakness, diarrhea, fever, muscle spasms
  • not life threatening
24
Q

opiate w/d interventions-5

A
  • narcan-w/d in 10 min
  • clonidine- mon BP
  • methadone-heroine
  • fluids
  • treat somatic symptoms
25
Q

stimulant drug types-4

A
  1. amphetamines
  2. cocaine
  3. synthetic stimulants
  4. prescription non-amphetamine stim drugs
26
Q

cocaine change in brain chem

A

imbalance of dopamine and norepi

27
Q

amphetamine change in brain chem

A

destroy brain cells that contain dopamine and seratonin

28
Q

amphetamine and cocaine med emergency-3

A

chest pain, irregular pulse, or hx of heart disease

29
Q

amphetamine intox sym-4

A
  1. increased energy and euphoria
  2. impaired judgement, hypervigilance, irritability, psychomotor agitation
  3. delerium and delusional
  4. acute cardio effects
    - high risk for violence
30
Q

tweaking safety-6

A
  • most dangerous
  • 7-10 ft distance
  • slow low voice
  • slow movements
  • keep hands visible
  • keep them talking to keep delusions at bay
31
Q

amphetamine w/d sym-4

A

not life threatening

  • “crashes”
  • wakes w ravenous appetite
  • starts to crave
32
Q

cocaine w/d

A

can precipitate suicidal ideation

33
Q

cocaine and meth w/d interventions-4

A
  • decrease stim
  • inject antipsychotic and benzodiazepine if agitated
  • antidepressants
  • bromocriptine-regulation of dopamine and cravings
34
Q

hallucinogen sym-6,5

A
  • tachycardia, dilated pupils, sweating, palpitations, blurred vision, tremors
  • altered perceptions, depersonalization, paranoia, depression, intense anxiety
35
Q

hallucinogen treatment

A

-don’t leave alone, reassure in plesant environment

36
Q

PCP intox sym-4,2

A
  • beligerance, superhuman stregnth, bizarre behaviors, risk of suicide
  • haldol and ativan for agitation
37
Q

codependancy char-3

A
  • self worth depends on others
  • feels responsible for others happiness
  • commonly denies prob exists
38
Q

RN diagnoses-8

A
  1. ineffective denial
  2. ineffective coping
  3. imbalanced nutrition
  4. risk for infection
  5. chronic low self esteem
  6. deficient knowledge
  7. risk for injury
  8. risk for suicide

Psych (8 decks)

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