Week 5 & 6

Question 1

What is the difference between hazardous substance use and harmful substance use

Answer 1

Hazardous substance use are substances, mixtures and articles that can pose a risk to health and safety.
Harmful substance use is a pattern of psychoactive substance use that is causing damage to health.

Question 2

Define addiction

Answer 2

Being dependent to a particular substance or activity; changing the neurological pathways in a person’s brain

Question 3

Explain the mechanism of action of addiction

Answer 3

• The brain’s reward pathway is designed to become stimulated to reinforce survival patterns (such as eating for fuel, or procreating), thus releasing endorphins and dopamine
• Some substance and behaviours can also trigger the same response from the reward pathway of the brain, resulting in euphoria
• This can lead to addiction as the person becomes dependent on these substances and behaviours to stimulate the brain’s reward pathway

Question 4

Define dependence

Answer 4

it is the state of relying on or being controlled by someone or something else
-it is the body’s psychological adaptation to long term substance misuse
-dependence on a substance can also occur in the absence of addiction

Question 5

Explain the term withdrawal

Answer 5

A withdrawal syndrome can occur when substance use stops
-withdrawal syndrome is associated with the experience of a range of physiological and mental health symptoms that can be mild or in severe cases life threatening

Question 6

What are the signs and symptoms of problematic substance use?

Answer 6

-the substance is taken in larger amounts over a longer period of time than intended
-there is persistent desire or unsuccessful efforts to cut down or control the substance
-a great deal of time is spent in activities necessary to obtain the substance, use the substance or recover for it’s effects
-craving, or a strong desire to use substance
-recurrent substance use resulting in a failure to fulfil major role obligations
-continued substance use despite having persistent or recurrent social or interpersonal problems caused by the effects of the substance

Question 7

What are the treatment options for substance misuse?

Answer 7

-community/inpatient settings, addiction wards
-intervention and treatment modalities
-psychological therapies include group, family, and individual sessions
-motivational interviewing; CBT, AA, NA
-pharmacotherapy treatments; oral naltrexone, alcohol, opioids (methadone, buprenorphine)

Question 8

What is the role of the nurse when caring for patients dealing with addiction?

Answer 8

encouraging fluids, nutrition, rest, monitoring vital signs, neurological observations, level of consciousness, detailed drug and alcohol assessment, document and record all observations

Question 9

What are the social impacts of substance use?

Answer 9

poor relationships/friendships, social isolation/exclusion, neglect when younger, influenced to do the same as parents

Question 10

What are the physical impacts of substance use?

Answer 10

exposure to more illnesses/diseases such as cancer or heart related conditions

Question 11

What are the psychological impacts of substance use?

Answer 11

Anxiety and depression

Question 11

What is substance use disorder?

Answer 11

When anything ingested alters or affects a person’s mood, cognition, thinking, perception, behaviour and consciousness
-also referred to as psychoactive, as these substances commonly have effects on the CNS

Question 12

Define personality disorder

Answer 12

conditions associated with impairment in cognition, affectivity, impulse control and interpersonal functioning.
There are three clusters of personality disorders; cluster A, cluster B and cluster C

Question 13

Define borderline personality disorder (BPD)

Answer 13

Personality disorder characterised by severe mood swings, impulsive behaviour, and difficulty forming stable relationships

It is indicated by 5 or more of the following:
-fear of abandonment
-a pattern of unstable and intense interpersonal relationships
-identity disturbance
-impulsivity
-recurrent suicidal behaviour
-chronic feelings of emptiness
-inappropriate intense anger or difficulty controlling anger

Question 14

What are the signs and symptoms of BPD?

Answer 14

-fear of abandonment
-extreme mood swings
-unstable relationships
-impulsive, self-destructive tendencies
-unstable self-image
-self-harm
-paranoia, disassociation
-chronic feelings of emptiness

Question 15

Identify the genetic factors in regards to the causes of personality disorders

Answer 15

More common in those with a family history of substance misuse

Question 16

Identify the biological factors in regards to the causes of personality disorders

Answer 16

First degree relative with a personality disorder diagnosis. ACE’s such as neglect and abuse

Question 17

Identify the environmental factors in regards to the causes of personality disorders

Answer 17

Hx of childhood trauma. Low SES is correlated to the increased risk of the development of a personality disorder

Question 17

What are the treatment options for personality disorders?

Answer 17

1. Pharmacological management:
   -antipsychotics
   -antidepressants
   -mood stabilisers
2. Talk therapies
   -dialectical behaviour therapy (DBT)
   -acceptance and commitment
   -therapy (ACT)

Question 18

What is the role of the nurse when caring for a person with BPD?

Answer 18

-risk assessment
-mental state examination
-short term goals
-long term goals
-circumstances which may cause or exacerbate risk
-personalised effective coping strategies in times of distress
-self-management strategies; using an electric band on their wrist/arm or the use of ice blocks
-emergency contact details (family, case manager etc)
-roles and responsibilities of primary care providers
-review dates

Question 19

What is the difference between transference and countertransference?

Answer 19

Transference occurs when the consumer unconsciously transfers feelings or emotions that were experienced previously (usually from their clinician) to their current relationship with their children.
Countertransference occurs when the clinician unconsciously transfer their feelings of previous experience onto another consumer. Often associated with negative experiences with a condition

Question 19

Define suicide

Answer 19

it is the deliberate act of ending one’s life and is considered an intentional act

Question 20

What are some examples of suicide risk factors?

Answer 20

-being male
-socially isolated
-aboriginal/torres strait islander heritage
-AOD use
-LQBTQI+ community
-migrant/refugee population
-family violence

Question 21

What is static risk? Provide examples

Answer 21

Static risks are risk factors fixed and historical in nature
-history of self injury
-previous psychiatric hospital admissions
-history of mental illness
-past childhood trauma
-history of substance use/misuse
-personality disorders/traits
-age, gender, marital status

Question 22

What is dynamic risk? Provide examples

Answer 22

Dynamic risks are risk factors that fluctuate in duration and intensity and are present for an unknown length of time
-suicidal ideation and intent
-hopelessness
-problem solving deficits
-active psychological symptoms
-substance use
-psychosocial stress
-access to support and services

Question 23

Define self-injuring behaviour

Answer 23

it is the physical act of harming or hurting yourself

Question 24

How is self-injury a risk?

Answer 24

-the person can sever an artery which can be fatal
-risk of local and systemic infection
-people can experience social exclusion if they have visible self harm injuries or scars
-indicates underlying mental health concerns

Question 25

What are the possible reasons for self-injuring behaviour?

Answer 25

-emotional dysregulation
-anger
-self-punishment
-to prevent feeling numb
-release tension of built-up emotions
-gain a sense of feeling in control
-interpersonal- communicating that support is needed