Definitions
This is an episode during which the person continues to function but has no conscious awareness of his or her behavior at the time or any later memory of the behavior.
Blackout
This type of substance causes one to initially feel relaxed and experience a loss of inhibitions. Too much of this can cause slurred speech, unsteady gait, lack of coordination, and impaired attention.
Alcohol intoxication
Overdose from this substance can lead to coma, respiratory depression, pupillary constriction, unconsciousness, and death. However, the administration of this medication reverses all signs of opioid toxicity.
(2-part question)
1-Heroin
2-Narcan (naloxone)
This is the initial priority in substance withdrawal, focusing on physical needs, and may include safety:
Detoxification
This medication may be prescribed to help deter clients from drinking alcohol by causing severe reactions (HA, sweating, n/v) when taken with alcohol.
Disulfiram (Antabuse)
What is the term for needing more and more of a substance to achieve the same effect?
Tolerance
These types of drugs stimulate or excite the central nervous system and have limited clinical use, and HIGH potential for abuse.
Stimulants (Amphetamines, Cocaine)
*with the exception of those used to treat ADHD
(1) These symptoms of withdrawal usually appear 4-12 hours after cessation or marked reduction of this substance (2):
(two-part question)
1- hand tremors, sweating, elevated pulse and BP, insomnia, anxiety, and nausea or vomiting.
2-Alcohol
What are some types of screening tools used in the assessment process? Name two:
- Nursing assessment/HX/questionaire
-Simple Screening Instrument for Alcohol and Other Drugs (SSI-AOD)
-Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-AR)
This synthetic opiate is used as a substitute for heroin in some maintenance programs:
Methadone
Administering decreasing doses of a medication is called:
Tapering
This classification of drugs cause the desensitization of both the physiologic and psychological pain, and induce a sense of euphoria and well-being.
Opioids
This substance has no reported withdrawal symptoms, other than reported cravings for more of this drug.
Inhalants
Name at least 2 nursing DX that may pertain to a client dealing with detoxification or withdrawal:
Imbalanced nutrition: risk of non-compliance with medications, less than body requirements; Risk for infection; Risk for injury; Diarrhea; Excess Fluid Volume; Activity Intolerance; Self-Care Deficits; Risk of relapse; Risk for poor self-image
What are the two main purposes in pharmacological treatment in substance abuse?
1- to permit safe withdrawal from the drug/substance being abused
2- to prevent relapse
Abuse of more than one substance is called:
Polysubstance abuse
These classes of drugs includes all central nervous system depressants:
(name at least 3)
Barbiturates, nonbarbiturate hypnotics, (alcohol) and anxiolytics- particularly benzodiazepines.
These withdrawal symptoms are characterized by symptoms that are opposite of the acute effects of the drugs: increased pulse, BP, respirations, and temperature.
Which class(s) of drugs will cause these withdrawal effects?
Sedatives, Hypnotics, and Anxiolitics
What are some desired outcomes for a client with substance use? List 3:
The client will:
Abstain from alcohol and drug use; Will express feelings openly and directly; Will verbalize acceptance of responsibility for his/her own behavior; Will practice non-chemical alternatives to deal with stress or difficult situations; Will establish an effective aftercare plan.
What combination drug is used for opiate maintenance and to decrease opiate cravings, but also has the potential for abuse and diversion?
Buprenorphine/naloxone (Suboxone)
This term includes problems associated with addiction such as tolerance, withdrawal, and unsuccessful attempts to stop using the substance.
Substance Dependence
This substance can cause symptoms such as:
Increased HR, BP, temperature, dilated pupils, hyperreflexia, sweating, blurred vision, anxiety, depression, paranoid ideation, and possibly aggression.
(oh, and distorted perceptions of reality....)
Hallucinogens
Withdrawal from this substance can be life-threatening, and detoxification needs to be done under medical supervision, using this commonly used medication:
(2-part)
1-Alcohol
2- Benzodiapepines
What is the most crucial element to educate a client about, and should be taught by nurses, doctors, therapists, support groups etc.?
Relapse
1-This maladaptive coping pattern can result from family members or others that have had a prolonged relationship with the person using substances. (Otherwise known as enabling)
2-What can nurses do to halt this behavior, encourage independence for the patient, and help reduce probability of relapse?
1-Codependence
2-Client and family education about addiction and relapse; help identify problem areas where drugs hurt instead of helped; educate and encourage med-compliance where necessary; help search out support groups in the area, etc.