Alcoholics Are Apart An AA And Administer medicAtion
Anticonvulsants/barbiturates
withdrawal
-SE: seizures
Reactive attachment disorder.
Most important thing to assess in a patient who expresses somatization.
nutrition, fluid balance, and elimination.
At a OSU party, an alpha beta delta member approaches you. He makes small talk but appears to be angry/cursing and constantly checks his surroundings as if someone is coming for him. He mumbles something about chest pain and you conclude he is having arrhythmias.
Stimulant use disorder intoxication.
Trauma-informed care
focused care on past experiences and how they play a role in patient's life.
Naltrexone
Withdrawal, relapse, prevention, decrease pleasurable feelings, and cravings for BOTH opioids & alcohol.
- 10 days opiate free to begin medication.
A person is weirdly attached to their dog. One day the owner found out their dog and the neighbor's dog got a little action...but didn't use protection. Therefore, the owner's dog got HIV and died. The owner became depressed and tearful whenever a dog is seen. Within 6 months, the owner was gifted a new dog and got over it.
Adjustment disorder
A patient in her second trimester was recently diagnosed by her HCP that she has stage IV cervical cancer that has spread to her baby and her heart as well as has cause her to be anemic. She smiles and replies, "Thats interesting. Glad my eyes are still working so I can watch twilight! Thanks for your help doc!" What just happened?
La belle indifference.
You received a cookie in the mall by someone special. You devour the cookie unaware it was lace with cocaine. What S&S would you experience from a stimulant withdrawal?
tiredness, vivid nightmares, increased appetite, insomnia/hypersomnia, and psychomotor retardation.
What are some predictors of violence?
hyperactivity (most important)
increased tension, verbal abuse, loud voice, stone silence, possession of weapon.
Clonidine
mild-moderate withdrawal.
-SE: dizziness, hypotension fatigue, and headache.
Explain what and who can perform EMDR
rapid eye movement while expressing feelings performed by advanced practice.
What medical disease can increase risk for MDD?
Opioid withdrawal
You are looking in a patien't file and notice several charges for misconduct. Your eyes graze upon charges upon charges. What are you thoughts and S&S about this patient?
risk for aggression.
-S&S: closed off body language, suicide ideation, difficulty with simply takss, poor solving-problems, and feelings of impatience.
Disulfiram
maintenance, relapse, and prevention/aversion therapy.
-avoid all alcohol.
An adult who has recently experienced trauma and is suffering from PTSD has been admitted to the unit. What medications can the nurse anticipate administering?
SSRI: sertraline or paroxetine
SNRI or TCA: trazadone.
NO BENZO due to depression.
You're friend who you have noticed believes they have a second head with it's own mind growing on their back when in reality its just another pimple. The friend persistently complains about the pain. How do you interact with the friend as a nurse?
After complains been investigated, do not continue to check when they complain.
- focus less on physical and more on emotion.
- Medication: TCA/SSRI, SNIR, and short benzo (not recommended).
After visiting the cat cafe in Cincinnati you decide to take a stroll down a sketchy area of town. You come across a homeless person who has slurred speech, can't remember what year it is, and is moving slowly as if a sloth. The person also appears happy and instantly switches to angry.
opioid intoxication
You are a student nurse at KBMC. You accidently tell a lady that looks bueatiful today bc of her new blouse her friend brought in for you. She become angry and defensive yelling "I HAVE A GIRLFRIEND!". What medication do you think she has PRN?
antianxiety agents: lorazepam (1st)
1st gen and 2nd gen antipsychotics.
Acamprosate calcium
relpase prevention
- SE: diarrhea, GI upset, appetite loss, dizziness, anxiety, and difficulty sleeping.
Dissociative identity disorder
There are four men in a tub. Man A explains he fakes his cancer just so his sister can cook top ramen for him. Man B reports he can't focus on work because of his fear of this intense pain from a bee sting. Man C talks about how he doesn't have the money for dental insurance so he fakes tooth aches. Man D reports he went for a CT head scan after hitting his head with a pillow and worries that he possibly has a brain tumor/bleed. Describe each's disorder.
Man A: Secondary gains
Man B: somatic sypmtom disorder
Man C: Malingering
Man D: Illness anxiety disorder
Pt is referred to inpatient treatment and therapy for stimulant use disorder. What medication is anticipated to educate the patient on?
antipsychotics, benzo, and antidepresseants (used after withdrawal).
Right: camly reassures patient, validates emotions, and decreases stimuli.
Wrong: yanking patient to room and setting a limit on his angerness.