Withdrawal
How many days of Meth w/d do we give?
None - Stimulant w/d is not life threatening
If someone reports SOB or asthma what should you look for?
See if they have a rescue inhaler in the cabinet in the med room
If someone appears to be having hallucinations or reports hallucinations what do we do?
Put them on a 15/3 MH watch
List 3 Signs of a true seizure
1. altered VS (low O2, elevated HR) 2. unresponsive to stimulus 3. postictal
What type of DM is insulin dependent?
Type 1
How many days of withdrawal protocol does an inmate receive for Opiate and ETOH withdrawal?
Opiate - 7 days
ETOH - 4 days of Librium, 14 days of Vitamins, 6 day BB/tier restriction
What is the respiratory characteristic of Asthma?
Wheezes
Who is the head of the MH department?
Dr. McGreevy
What are the 3 most common causes of seizures seen in the facility?
Epilepsy, Pseudo, or W/D seizures
Name 3 things you should or shouldn't do during a seizure
DO: move any objects that can cause harm away from the inmate, protect their head during the seizure, place in a recovery position after the seizure
DON'T: Hold them down, put anything in their mouth or force their jaw open
What are the severe sxs of ETOH w/d?
Seizures, hallucinations, fever, severe confusion, irregular HR, profuse sweating
What are the 2 types of insulin given in our facility?
Humalog (rapid acting) and Lantus (long acting)
If someone is acting erratic or appears paranoid in intake what should you do?
Call medical to come check them
What is it called when a Seizure occurs in the brain?
Electrical storm
What is the state of mind following a seizure called?
Postictal
When can ETOH withdrawal begin?
can begin as early as 2 hours after the last drink
Name 3 signs and symptoms of hypoglycemia (low BS)?
1. shaky 2. Clammy/sweaty 3. Confused
How many types of Excited Delirium are there? Which is the most concerning?
3-Hyper-active, Hypo-active, Mixed
Hypo-active has the highest mortality rate
What do you do after seizure like activity has stopped?
Lay them in the recovery position
What can happen during W/D especially if the patient has N/V/D?
Severe dehydration requiring IV fluid resuscitation
What is the potentially fatal version of ETOH withdrawal called?
Delirium tremens (DTs)
What are the 3 Ps of hyperglycemia?
Polydipsia (excessive thirst), Polyuria (excessive urination), Polyphagia (excessive hunger)
Name 5 signs & symptoms of agitated excited delirium
Agitation, violent behavior, bizarre behavior, insensitivity to pain, elevated VS -temp, HR, BP, increased strength
What are the 3 types of seizures?
Absence (petit mal), Partial complex (focal), tonic clonic (grand mal)
What is the rebound phenomenon known as in ETOH W/D?
Brain hyper excitability