PREPU CHPT 19

Naloxone (Narcan)

A 20-year-old client arrives at the emergency department by ambulance. The client is unconscious, with slow respirations and pinpoint pupils. There are "tracks" visible on the client's arms. The friend who came with the client reports that the client had just "shot up" heroin when the client became unconscious. Which medication would the nurse most likely expect to administer?

elevated temperature

A nurse suspects that a client is experiencing alcohol withdrawal based on assessment of which of the following?

Substance abuse disorders

A nursing student is aware that which accounts for more deaths, illnesses, and disabilities across the life span than any other preventable condition?

substance abuse disorder

A nursing student is aware that which accounts for more deaths, illnesses, and disabilities across the life span than any other preventable condition?

Imbalanced nutrition: less than body requirements related to chronic alcohol intake

A 47-year-old client has been admitted to the hospital after being found unconscious in a park. Upon regaining consciousness, the client admits to heavy alcohol use over many years. Assessment reveals a low body mass index, low electrolyte levels, and impaired skin integrity. Vital signs are within normal ranges. What nursing diagnosis should be prioritized in the care of this client?

Risk for injury

A 52-year-old client has a history of alcohol dependence and is admitted to a detoxification unit. The client has tremors, is anxious, has a pulse that has risen from 98 to 110 beats/min, has blood pressure that has risen from 140/88 to 152/100 mm Hg, and has a temperature 0.6º above normal. The client is slightly diaphoretic. Which nursing diagnosis would be the priority?

Chlordiazepoxide (Librium)

A client admitted for acute alcohol intoxication begins to experience mild sweating, tachycardia, fever, and nausea and vomiting. Of the following, the drug treatment of choice would be what?

8

A client can expect symptoms of alcohol withdrawal to begin how many hours after the last drink?

Delirium tremens

A client enters the emergency room exhibiting tremors, agitation, and restlessness. Upon assessment, the client's blood pressure is 160/90, pulse is 110, and respirations are 22. It has been 36 hours since the client's last drink of alcohol. The nurse would suspect which conditions to be occurring?

tremors, seizures; increased temperature, pulse and blood pressure; and delirium tremors

A client experiencing alcohol withdrawal may exhibit

Reduces the appeal of alcohol

A client has been prescribed naltrexone for treatment of alcohol dependence. The nurse has explained the drug's purpose to the client. The nurse determines that the client has understood the instructions when the client identifies which about the drug?

"What negative consequences have resulted from your drinking?"

A client has entered treatment for alcohol dependency at the client's spouse's insistence. The client's spouse has threatened to leave the marriage unless the client seeks treatment. The client admits that the client drinks every day, but that the drinking is well in control. The nurse recognizes the client's comments as denial. What is the best response by the nurse?

on Monday morning

A client is admitted to the detoxification unit on Sunday evening. The client discloses that the client's last alcoholic drink was just before the client was admitted to the unit. When can the nurse expect that the client's alcohol withdrawal symptoms will begin?

Hallucinogen

A client is admitted to the emergency department after using MDMA (Ecstasy). The nurse identifies this drug as which of the following?

Wernicke-Korsakoff syndrome

A client is admitted to the emergency department for intoxication with alcohol. The client has an unsteady gait, myopathy, and neuropathy and cannot remember past or recent events. When treated with thiamine, the client's symptoms greatly improve. Which condition was the client likely experiencing?

Seizures Cardiac arrhythmia

A client is brought to the emergency department after having overdosed on cocaine. When assessing the client, which would the nurse expect to find?

Marked diaphoresis Auditory hallucinations Gross uncontrollable tremors

A client is experiencing severe alcohol withdrawal. Which would the nurse most likely assess?

The spouse will refrain from the enabling the client's drinking behaviors.

A client is in treatment for depression and alcohol abuse. The client is unwilling to confront substance abuse issues, stating the client uses alcohol to ease feelings of depression. The client's spouse reports that the spouse often has to care for the client when the client is hung over, calling in sick for the client and doing what the spouse can to help the client catch up with household or job responsibilities. The nurse diagnoses the client's family with dysfunctional family processes. The nurse and clients develop a plan of care. Which goal indicates an understanding of the family situation and the linkages between the diagnosis and the outcomes?

"It can help to prevent you from drinking."

A client is prescribed disulfiram as part of the alcohol treatment program to prevent relapse. The client asks the nurse, "How will this drug help me?" Which response by a nurse would be most appropriate?

"I should eat small frequent meals if I get nauseated."

A client is receiving methadone maintenance therapy. After teaching the client about this treatment, the nurse determines that the education was successful when the client states what?

"I realize that there is a higher power that can help me."

A client with a history of alcohol abuse is participating in a 12-step Alcoholics Anonymous (AA) program. The nurse determines that the client is at step 2 when stating what?

Korsakoff's psychosis

A client with a long history of alcohol abuse has presented to the emergency department with hallucinations and an incoherent story about being followed by the police. The client is likely experiencing which physiologic effect of alcohol use?

Thiamine, or vitamin B1, deficiency

A client with chronic alcoholism has been found to have Korsakoff's psychosis. This irreversible complication is characterized by what?

The drug helps to satisfy the craving for the opioid.

A client with opioid addiction is prescribed methadone maintenance therapy. When explaining this treatment to the client, which of the following would the nurse need to keep in mind?

Naloxone

A group of nursing students is reviewing information about nutritional supplementation used during alcohol detoxification. The students demonstrate the need for additional review when they identify which of the following as being used?

Hallucinogens

A nurse is caring for a client who uses phencyclidine (PCP). PCP is classified as which type of substance?

Use of marijuana does not lead to addiction.

A nurse is conducting a class for a group of high school students about marijuana use and abuse. The nurse determines that the class needs further discussion when they state which of the following?

vomiting, unconsciousness, and respiratory depression.

An overdose, or excessive alcohol intake in a short period, can result in

Methadone (Dolophine)

After a long history of intravenous heroin use, a client has expressed willingness to stop using heroin. The nurse would expect the client to receive which medication to decrease the severity of withdrawal?

Verbalize feeling safe and comfortable.

An appropriate goal for a client newly admitted to the unit for alcohol withdrawal is what?

vomiting

High doses of alcohol produce which effect?

12

In a person who abuses alcohol or is a chronic drinker, alcohol withdrawal syndrome usually begins within which time frame from abrupt discontinuation or an attempt to decrease consumption?

Wernicke-Korsakoff syndrome

Organic brain syndrome resulting from prolonged heavy alcohol use, involving confusion, unintelligible speech, and loss of motor coordination. It may be caused by a deficiency of thiamine, a vitamin metabolized poorly by heavy drinkers.

Benzodiazepines

Safe alcohol withdrawal usually is accomplished with the administration of which medication classification?

lorazepam, chlordiazepoxide, or diazepam, to suppress the withdrawal symptoms.

Safe withdrawal usually is accomplished with the administration of benzodiazepines, such as

4 to 12 hours after cessation or marked reduction of alcohol intake.

Symptoms of withdrawal usually begin

The client most likely has a dual diagnosis since she has both a substance dependence and depression.

The client was diagnosed with cocaine abuse at age 30. When the client was 23, the client was diagnosed with major depressive episode, and has continued to have depression off and on since then. Which statement would reflect this situation?

Dopamine

The ingestion of mood-altering substances stimulates which neurotransmitter pathway in the limbic system to produce a "high" that is a pleasant experience?

Adolescents

The mental health nurse is preparing a presentation about prescription drug abuse to a local community group. When describing the incidence, which age group would the nurse identify as experiencing an increase?

Asians

The mental health nurse recognizes that genetic intolerance of alcohol has been documented among which ethnic group?

Both genders between the age of 12 and 17

The mental health nurse should focus on preventative efforts including educational interventions related to the abuse of prescription drugs on which client group?

Help them to identify appropriate diversional activities.

The nurse in an outpatient rehabilitation program is speaking with a group of clients who have recently recovered from alcohol abuse. Which issue should the nurse raise before the clients leave for the day?

All the conditions are attributable to the alcohol abuse

The nurse is performing a history and physical examination on a client with chronic alcoholism. The client has a history of gastritis, esophagitis, elevated liver enzymes, cardiomyopathy, and pancreatitis. Which of these conditions are attributable to the client's history of alcohol abuse?

"Your parent's alcohol use problem is a chronic disease but can be treated."

The nurse is providing support to a client's child regarding the parent's alcohol use disorder. When integrating the disease concept treatment approach about this type of disorder, which statement by the nurse would be most effective?

Tactile hallucinations

The psychiatric nurse managing the care of a client experiencing alcohol withdrawal instructs unit staff to anticipate that the client may experience which neurological response?

Helping the client identify positive coping mechanisms

When a client is working toward the prevention of an alcohol abuse relapse, the nurse is acting in a therapeutic role when doing what?

The client had six drinks a few hours ago.

Which factor would contraindicate the use of disulfiram in the treatment of a client who has an alcohol use disorder?

Thiamine (vitamin B1)

Which medication is used to prevent Wernicke-Korsakoff syndrome?

Lorazepam (Ativan)

Which medication is used to prevent alcohol withdrawal symptoms?

Substance-related disorders result from the interplay of biologic, genetic, and psychosocial factors.

Which statement most accurately describes the etiology of substance-related disorders?

It is a legal medication. It is controlled by a health care provider. It is available in tablet form.

Which statements identify positive aspects of methadone as a substitute for heroin?

Tolerance break

Which term describes a situation that occurs when very small amounts of alcohol intoxicates the person after continued heavy drinking?

CIWA-Ar

While conducting an admission interview with a client, the nurse suspects the client may be in alcohol withdrawal. Which screening tool can help the nurse identify the severity of withdrawal symptoms?

Methadone

given to clients who abuse opioids and synthetic substances to replace their usual substance of abuse because it decreases the severity of withdrawal.

Korsakoff's psychosis

involves gait disturbances, short-term memory loss, disorientation, delirium, confabulation, and neuropathy.

a blackout

is an episode during which the person continues to function but has no conscious awareness of his or her behavior at the time or any later memory of the behavior.

Wernicke's encephalopathy

is characterized by ataxia, nystagmus, ophthalmoplegia, and mental status changes.

Wernicke-Korsakoff syndrome

is the coexistence of Wernicke's encephalopathy and Korsakoff's psychosis.

Tolerance occurs

when the person needs more alcohol to produce the same effect. Intoxication is use of a substance that results in maladaptive behavior.