COWS assessment
5-12
What are some communities that may be more susceptible to addiction and substance abuse?
chronic illness and/or pain, child of a parent with addiction, mental health disorders, individuals put under overwhelming pressure, drug use early in life,
What is the name of the opioid antagonist drug?
Naloxone (Narcan)
When does the current opioid crisis date back to?
Late 1990s
intoxication
slurred speech, impaired memory, decreased respiratory rate, decreased LOC, impaired judgement, impaired functioning
What is the range for a moderate score?
13-24
What are programs available to those suffering from addiction?
Narcotics Anonymous, Alcoholics anonymous, Al-anon (for family members), rehabilitation facility, SAMHSA national helpline
what should you do if you suspect a coworker is actively struggling with substance use addiction?
Report your concerns to your charge nurse and or higher members of the management team as needed
What is phase one of the opioid crisis?
relates to prescription painkillers in the 90s
withdraw
diaphoresis, tremors, irritability, weakness, diarrhea, fever, insomnia, pupil dilation, nausea/ vomiting, pain, muscle spasm, seizures
what is the range for moderately severe?
25-36
What is the current capital of the opioid epidemic in the US?
Huntington, West Virginia
vital signs, neuro status, telemetry, auscultate lungs for adventitious sounds, seizure precautions, encourage adhering to the treatment plan, educate about meds and NA
What is phase two related to in the opiod crisis?
characteristics of drug seeking
aggressive personality, exaggerating symptoms or medical problems, frequent ER visits, mood disturbances, requesting specific drugs
what is the range for severe withdraw?
over 36
Risk factors for addiction?
Individuals born lacking the proper neurotransmitters associated with pleasure and pleasurable activities, family and home life, friend groups, low self esteem, trauma, stress, few life successes, child of addict
What meds might be used to assist with withdraw symptoms?
methadone, clonidine, buprenorphine, naltrexone
What does phase three relate to in the opioid crisis?
Related to synthetic opioids such as fentanyl, began in 2013 and is still ongoing
drug seeker manipulation examples?
demanding to be seen right away, may fake intense pain, will use an older person or child to obtain drugs, propose the physician to prescribe more medication than originally intended, report that medication is lost or stolen
resting pulse rate, sweating, restlessness, pupil size, bone or joint aches, runny nose or tearing, GI symptoms, tremors/ yawning, anxiety/irritability, goosebumps
What is the origin of opioids?
Name some interpersonal care team members?
social work, hospitalist, cardiology, respiratory therapy, addiction nurses, pain management team
Around 6 deaths per 100,000
You walk into your patients room and perform a COWS assessment. You find a HR of 65, patient denies stomach cramps, diarrhea, and chills. Patient sitting still, pupils are possibly larger than normal for room lighting, patient reports mild joint discomfort, runny nose and apparent tearing absent, tremors absent as well. Patient is obviously irritable. Patient yawns once during assessment. Would you consider this to be a mild or moderately severe COWS score?
mild