Addiction Questions
A 20-year-old homeless client at 38 weeks' gestation visits the prenatal clinic for the first time. She is accompanied by her 21-year-old boyfriend, who is the father of the baby. The nurse becomes concerned because as they sit in the waiting room, they are sneezing and yawning and have teary eyes. With what substance are these withdrawal signs associated? Heroin Cocaine Morphine Phenobarbital
Heroin Research indicates that sneezing, yawning, and teary eyes are the first physical signs of withdrawal from heroin. Depression and irritability accompany withdrawal from cocaine. Restlessness, shakiness, hallucinations, and sometimes coma accompany withdrawal from morphine. Insomnia, seizures, weakness, sweating, and anxiety accompany withdrawal from phenobarbital.
Typical signs of neonatal abstinence syndrome related to opioid withdrawal usually begin within 24 hours after birth. What characteristics should the nurse anticipate in the infant of a suspected or known drug abuser? Select all that apply. Tremors Dehydration Hyperactivity Muscle hypotonicity Prolonged sleep periods
Hyperactivity Tremors Opioid dependence in the newborn is physiologic; as the drug is cleared from the body, signs of drug withdrawal become evident. Tremors and hyperactivity are typical signs of cerebral irritability. Dehydration is a result of inadequate feeding, not a direct result of opioid withdrawal. Muscle hypertonicity, not hypotonicity, occurs with opioid withdrawal. Signs of opioid withdrawal include excessive activity and sleep disturbances.
A newborn is diagnosed as having neonatal abstinence syndrome (NAS) after exhibiting jitteriness, irritability, and a shrill cry. What is the priority nursing care? Administering an opioid antagonist Limiting fluid intake to inhibit vomiting Assessing for age-appropriate developmental level Reducing environmental stimuli to promote relaxation
Reducing environmental stimuli to promote relaxation The neonate who is withdrawing from opiates is very sensitive to light, noise, and surrounding activity; the infant must be kept calm and comfortable to reduce overreaction to stimuli. Morphine or other opioids are administered to those infants who have loose stools and other gastrointestinal problems resulting from withdrawal. Some of these infants need tranquilizers or sedatives to minimize the effects of withdrawal. An opioid antagonist would lower the seizure threshold and is contraindicated in this clinical situation. Fluid intake must be increased to prevent dehydration in the infant who vomits. Assessment for developmental status is not the priority; physical needs take precedence.
What is most important for the nurse to do when caring for a client who is in an alcohol detoxification program? Accept the client as a worthwhile person. Provide nurturing because the client needs it. Discuss with the client the ill effects of alcohol. Promote compliance by gently prodding the client.
Accept the client as a worthwhile person. Clients who abuse alcohol characteristically have low self-esteem; therefore it is important for the nurse to accept the person as an individual with value.
A client with alcohol dependence is admitted to the detoxification unit. Which class of medication does the nurse anticipate that the healthcare provider will prescribe? Opiate Antipsychotic Antidepressant Benzodiazepine
Benzodiazepine
A client who was in an automobile accident is admitted to the hospital with multiple injuries. Approximately 14 hours after admission, the client begins to experience signs and symptoms of withdrawal from alcohol. Which signs and symptoms should the nurse connect to alcohol withdrawal? Select all that apply. Fatigue Anxiety Runny nose Diaphoresis Psychomotor agitation
Anxiety Diaphoresis Psychomotor Agitation
A nurse knows that individuals who are alcoholics use alcohol for what reason? Blunt Reality Precipitate euphoria Promote social interaction Stimulate the central nervous system
Blunt Reality Alcohol, by depressing the central nervous system and distorting or altering reality, reduces anxiety. Alcohol depresses the central nervous system; it may cause lability of mood, impaired judgment, and aggressive actions rather than euphoria.
As a client addicted to cocaine withdraws from the drug, what behavior should the nurse expect? Insomnia Depression Disinhibition Hyperactivity
Depression There is no set of symptoms associated with cocaine withdrawal, only the depression that follows the high caused by the drug. Insomnia is more commonly associated with withdrawal from central nervous system depressants. Disinhibition is commonly associated with alcohol intoxication. Hyperactivity is more commonly associated with withdrawal from opioids or antianxiety drugs.
The nurse explores the possibility of joining Narcotics Anonymous (NA) with a client who has a history of drug abuse. What is a major reason that NA is helpful in treating addictive behavior? More change will take place within the group. Correct Group members are supportive of one another's problems. Group members share a common background and history. Addiction problems are dealt with more effectively in a group.
Group members are supportive of one another's problems. Although members of the group may become impatient with one another's problems at times, the group is usually supportive. Members share common goals, and the opportunity is available to test out new patterns of behavior. The rate and degree of change are individually based variables. People with addiction problems have varied backgrounds; the only common denominator may be the addiction. Although many clients function well in a group, some clients cannot.
A young adult being treated for substance abuse asks the nurse about methadone. The nurse responds that methadone is useful in the treatment of opioid addiction because it has what characteristic? Is a nonaddictive drug Has an effect of longer duration Does not produce a cumulative effect Carries little risk of psychological dependence
Has an effect of longer duration The duration of effect of methadone is 12 to 24 hours, compared with other opioids, which have a 3- to 6-hour duration of effect. It is just as addictive but controls the addiction and keeps the client out of the illicit drug market. Methadone does produce a cumulative effect. Physical as well as psychological dependence is possible, just as with other opioids.
The nurse is caring for a newborn whose mother was prescribed an opioid analgesic throughout pregnancy. Which action should the nurse include in the plan of care? Offering small, frequent feedings Increasing the environmental stimuli Discouraging the mother from giving care Keeping the infant exposed in a heated crib
Offering small, frequent feedings Drug-dependent newborns are poor feeders due to hyperactivity, vomiting, respiratory distress, and excessive mucus; small, frequent feedings are given to prevent dehydration. These newborns need comforting. Swaddling and holding them provides comfort and protects them from self-stimulating behaviors. As a means of minimizing extraneous stimulation, environmental stimuli should be decreased. Encouraging the mother to provide care promotes mother-infant bonding.
What factors may cause an adolescent to develop a smoking addiction? Select all that apply. Peer Pressure Academic Success Involvement in sports Imitating adult behavior of smoking Imitating lifestyles portrayed in movies and achievements
Peer Pressure Imitating adult behavior of smoking Imitating lifestyles portrayed in movies and achievements
A primary healthcare provider prescribes oxazepam for a client who is beginning to experience withdrawal symptoms while undergoing detoxification. What are the primary reasons that oxazepam is given during detoxification? Prevents injury and protects the client when seizures occur Enables the client to sleep and eat better during periods of agitation Encourages the client to cooperate with and accept treatment for alcoholism Reduces the anxiety-tremor state and prevents more serious withdrawal symptoms
Reduces the anxiety-tremor state and prevents more serious withdrawal symptoms Oxazepam potentiates the actions of gamma-aminobutyric acid, especially in the limbic system and reticular formation and thus minimizes withdrawal symptoms. This drug helps reduce the risk for seizures but does not prevent injury or protect the client during a seizure. Enabling the client to sleep and eat better during periods of agitation is not the purpose of the drug. The ability of the client to accept treatment depends on the client's readiness to accept the reality of the problem.
A nurse, understanding the possible cause of alcohol-induced amnestic disorder, should take into consideration that the client is probably experiencing which imbalance? Thiamine deficiency A reduced iron intake An increase in serotonin Riboflavin malabsorption
Thiamine deficiency The deficiency of thiamine (vitamin B1) is thought to be a primary cause of alcohol-induced amnestic disorder. Reduced iron intake, increased serotonin, and riboflavin malabsorption are all unrelated to alcohol-induced amnestic disorder.