General
Opioids
Alcohol
Medications
Nursing Interventions
100

Characterized by loss of control due to substance use or behavior along with participation that continues despite continued problems and a tendency to relapse back into substance use or behavior

What are substance use and addictive disorders

100

Slurred speech, pupillary changes, memory impairment, decreased RR and LOC, maladaptive behavior

S/S of opioid intoxication

100

Slurred speech; nystagmus; impaired memory; altered judgement; decreased motor skills, LOC and RR; possible peripheral collapse and death 

S/S of alcohol excess

100

First line of treatment for alcohol withdrawal. Goals with use are to maintain VS within expected limits, decrease seizure risk and intensity of withdrawal manifestations. Before administering obtain baseline VS, monitor neurologic status and provide seizure precautions

Benzodiazepines (chlordiazepoxide, diazepam, lorazepam)

100

Fall prevention; seizure precautions; close observation; client orientation to person, place, time; maintenance of nutrition and fluids; low stimulation environment; administering medications as ordered; and monitoring for covert substance use are all important in ensuring this fundamental concept of care

Safety

200

Defense mechanism most commonly used by clients who have problems with substance use or addictive disorder

denial

200

Reversal agent/antidote for opioid overdose, can be administered IM, SQ, IV, intranasal

Naloxone HCL

200

Blood alcohol concentration (BAC) at which death could occur from acute toxicity

0.4% BAC (400mg/dL)

200

Competitive benzodiazepine receptor antagonist which can reverse effects of benzodiazepine toxicity. Administered IV

Flumazenil

200

Initial treatment goal when working with substance use and addictive disorders

abstinence

300

Age range with highest rate of substance use

18-25yrs

300

Routes of administration for heroin, morphine, hydromorphone

injected, smoked, inhaled, swallowed

300

Abdominal cramping; vomiting; tremors; sleep disturbance; increased HR, BP, RR and temperature; hallucination; anxiety; tonic-clonic seizure

 S/S of alcohol withdrawal

300

Medication used as type of aversion therapy. Concurrent use with alcohol causes acetaldehyde syndrome to occur which results in N/V, weakness, sweating, palpitations and hypotension. Symptoms have potential to progress to respiratory depression, cardiovascular suppression, seizure and death

Disulfiram

300

Self assessment of a nurses own feelings related to substance abuse, which may be impacted by their personal views, culture and history are important in ensuring this type of care is provided  

Objective, nonjudgmental nursing care

400

Substance which attaches to CNS receptors altering perception of and response to pain, leading to generalized CNS depression

 Opioid / Opioid agonist

400

Sweating, rhinorrhea, piloerection, tremors, irritability. Can progress to severe weakness, diarrhea, fever, insomnia, pupil dilation, N/V, pain and muscle spasms  

S/S of opioid withdrawal

400

Cardiovascular damage; liver damage (fatty liver, cirrhosis); erosive gastritis; GI bleeding; acute pancreatitis; sexual dysfunction

S/S of chronic alcohol use

400

Oral opioid agonist used to prevent abstinence syndrome (withdrawal symptoms) by transferring dependence from illegal opioid to this medication, which must be administered at an approved treatment center.  Doses can be slowly tapered to suppress withdrawal

Methadone substitution

400

Behavior in which a family member acts in an overly responsible manner which allows the dependent individual to continue their substance use or addiction disorder

codependency

500

Alcohol screening tool named for a Great Lakes state

Michigan Alcohol screening Test (MAST)

500

Opioid withdrawal includes many unpleasant symptoms but it is thankfully NOT this….

life threatening

500

Severe alcohol withdrawal S/S.  Can occur 2-3 days after cessation of drinking. May include severe disorientation; psychosis; severe HTN; cardiac dysrhythmias. Considered a medical emergency and can progress to death

Alcohol withdrawal delirium

500

Agonist-antagonist opioid substituted for an opioid to which client has dependence resulting in prevention of withdrawal symptoms and decreased feelings of craving.  Considered safer than methadone due to decreased risk for respiratory depression and lower potential for dependence.  Can be prescribed by primary care provider for SL administration

buprenorphine

500

Psychotherapeutic technique that uses relaxation and cognitive reframing to decrease anxiety and change behavior

cognitive behavioral therapy