W7 - Substance Related Disorder

Question 1

Whats the difference between substance abuse & substance dependence?

Answer 1

Abuse: Repeated use of drug -> no addiction, uncontrollable use / withdrawal symptoms when stop using

Dependence: Uncontrollable, repetitive use of a drug/alcohol -> withdrawal symptoms when they stop using

Question 2

Whats physical dependence of a drug?

Answer 2

• Body is accustomed to functioning with drug
• Doesnt mean drug abuse / addiction

Question 3

Why do HCPs fail to recognise, assess & intervene with alcohol & drug-related patients? (7)

Answer 3

1. Dont know what to do if/when they identify a pt
2. Dont believe in treatment
3. Helpless in helping pt change lifestyle
4. Negative attitude about pt
5. Misconception that pt has to be motivated for intervention to be effective
6. Unable to address denial, manipulation, hostility & drug-seeking behaviour
7. Nurses lack of response/response to the pt

Question 4

What is the goal of the nursing physical assessment? (2)

Answer 4

• find out presence & severity of withdrawal symptoms
• assess pts overall physical condition -> potential & existing nursing care problems

Question 5

How to assess patients who are experiencing withdrawal symptoms?

Answer 5

• recognise earliest signs of withdrawal
• assess vitals, esp pulse & monitor for withdrawal, esp diaphoresis (excessive sweating) & tremors
• pulse & temperature will rise before severe symptoms like hallucinations & seizures

Question 6

What is the goal of nursing care for withdrawl/detoxification?

Answer 6

Promote comfort, relaxation & prevent worsening of symptoms

Question 7

What are the signs & symptoms of alcohol withdrawal - mild, moderate & severe?

Answer 7

1. Motor impairment:
   - Mild: Inner + hand tremors
   - Moderate: visible tremors, obvious motor restlessness, painful anxiety
   - Severe: uncontrollable shaking, extreme restlessness & agitation, intense fear
2. Sleep
   - Mild: restless sleep/insomnia
   - Moderate: marked insomnia + nightmares
   - Severe: total wakefulness
3. Appetite
   - Mild: impaired appetite
   - Moderate: marked anorexia
   - Severe: reject all fluids & food except alcohol
4. GI
   - M nausea
   - M nausea + vomiting
   - S dry heaves + vomiting
5. Confusion
   - M none
   - M variable
   - S marked confusion & disorientation
6. Hallucination
   - M none
   - M vague, transient visual & auditory hallucinations & illusions, usually at night
   - S visual & occasionally auditory hallucinations, with fear / threats, misidentify ppl, frightening delusions related to hallucinations (very dangerous)