Sim 14
A nurse is reinforcing alcohol use disorder and is taking disulfiram. Which of the following statements should the nurse use in the teaching?
A: Avoid alcohol for 2 weeks after discontinuing the medication
Hyperactivity and paranoia are symptoms of the use of?
A: amphetamines
Which implementation can be used to help prevent relapse in a patient who has had substance abuse problems?
A: assisting patients to identify triggers to their substance use
A nurse is assisting in the development of a community education course about the physical complications related to substance abuse disorder. Which of the following physical complications should the nurse include about the use of heroin?
A: dental caries
A person with substance abuse disorder and has driven under the use of drugs and engage in excessive drug use..
A: injury
A nurse is caring for a client who is experiencing opioid withdrawal. Which of the following medications should the nurse suspect the provider to prescribe?
A: methadone
Controversial substance addict constitutes substituting another addictive drug misused by the patient?
A: methadone
Q: Signs and symptoms of a patient with withdrawal from alcohol
ANS: Agitation Anxiety Increased blood pressure, pulse, temperature Tremors Seizures Delirium Often includes visual hallucinations of animals
What are signs and symptoms patient who doesn't get his methadone on time
ANS: Agitation Tremors Sweating
Stimulants include what drugs
ANS: Amphetamines Methamphetamines Similar drugs to cocaine or "crack"
What drugs are used to help maintain abstinence from alcohol
ANS: Disulfiram (Antabuse) Naltrexone (ReVia) Acamprosate (campral)
What does alcohol abuse in the older adult place him or her at risk for?
ANS: Falls Malnutrition Bone demineralization Cirrhosis
Appropriate interventions for caring for the patient with alcohol?
ANS: Monitor vital signs Provide a safe environment Address hallucinations therapeutically Provide reality orientation as appropriate
A nurse is collecting data from a client who is experiencing alcohol withdrawal delirium, which if the following findings should the nurse expect? SATA
ANS: Seizures Hallucinations tremens
Q: Syndrome due to vitamin B1 (thiamine) deficiency
ANS: Wernicke encephalopathy Ataxia Confabulation Delirium decreasing level on consciousness
The nurses caring for a client who is suspected of being dependent on drugs, which question should be appropriate for the nurse to ask when collecting data form the client regarding drug abuse?
ANS: "when did you ingest the drug, how much do you use, and what effect does it have on you?"
How soon after stopping drinking will the patient experience second stage major withdrawal from alcohol?
ANS: 3 days
A hangover can begin about how many hours after the last drink
ANS: 4 to 6 hours after the last drink
How soon after stopping drinking alcohol will the patient expierence first stage early withdrawal from alcohol?
ANS: 6-12 hours
Which information about a patient should lead the nurse to suspect abuse?
ANS: Abnormal liver function test results and gastrointestinal (GI) bleed
Narcan has been given to a person with respiratory depression who is addicted to heroin. What should the nurse be alert for indication of?
ANS: Acute withdrawal symptoms
S/S of patient with withdrawal from alcohol?
ANS: Agitation, Anxiety, Increased blood pressure, pulse and temp, Tremors, Seizures, Delirium, Often include visual hallucinations of animals
The American Society of Addiction Medicine defines alcohol has a drug because
ANS: Alcohol has addictive qualities similar to those associated with other drug related disorders
What effect will occur if a patient being treat with naltrexone (ReVia) for substance abuse ingest opioids or alcohol?
ANS: An absence of the "high" associated with drugs
In some cases, patients will use drugs or alcohol to treat the disturbing symptoms of a psyciatric disease. What can occur in this scenario?
ANS: An accidental overdose by mixing alcohol with anxiolytic medications, antipsychotic medications, or antidepressants
Wernicke encephalopathy is caused by which deficiency?
ANS: B1
Which supplement should be given to individuals with chronic alcohol abuse?
ANS: B6 and folate
A patient with alcoholism doesn't know where he is or what day it is. What is he exhibiting?
ANS: Blackout
Q: Aaron who is a chronic alcohol abuser. Which problems are related to thiamine deficiency?
ANS: CNS symptoms: amnesia and peripheral neuropathy
Q: Physical complications related to substance abuse
ANS: Dental caries
What is the rationale for using methadone in the treatment of heroin abuse?
ANS: Does not give the "rush" that a person addicted to heroin is looking for
An alcoholic is brought into the emergency department in an intoxicated state at 2000. The day shift nurse assess the patient to exhibit tremors, have increased blood pressure, and agitation at 0800 rounds. What do these signs and symptoms indicate?
ANS: Early withdrawal
A nurse is caring for a client who has a history of alcohol use disorder and has been hospitalized for alcohol intoxication and the nurse enters the room and hears the client shouting "get those bugs off me" Which of the following responses should the nurse make?
ANS: I don't see any bugs but you seem very frightened
A nurse is teaching about alcohol withdrawal with a client who has a history of alcohol use disorder. Which of the following statements indicates understanding of the teaching?
ANS: I should expect hand tremors to start after I stop drinking
Q: Thiamin (B1) and Niacin deficiency?
ANS: Korsakoff psychosis
A patient with metastatic cancer is being admitted for pain control. Which action will the nurse preform in administering a transdermal patch?
ANS: Label the patch with date, time, dosage, and initials after patch placement
What is the rationale for administering acamproste (Campral)
ANS: Maintenance of sobriety
A patient has overdosed on opioids and is non responsive. What is the name of the medication you would give them?
ANS: Naloxone (Narcan)
What is the antidote for opioids
ANS: Naloxone (Narcan)
Which is an opioid antagonist?
ANS: Naloxone (Narcan)
A nurse is caring for an adolescent client who is undergoing detoxification. He states "I started using drugs after my parents didn't allow me to get a tattoo?" Which of the following defense mechanisms is the client demonstrating?"
ANS: Projection
A patient with an alochol addiction says, "My drinking is all my wifes fault. She makes me so crazy i just have to drink." What does this exemplify?
ANS: Projection
Which defense mechanism is used when people addicted to alcohol ship the blame onto their spouse?
ANS: Projection
What can help prevent relapse in a patient who has a substance abuse problem?
ANS: Teach them stress management
Q: Thiamin (B1) deficiency with delirium that could lead to a coma?
ANS: Wernicke encephalopathy
If a patient is using drugs or alcohol while taking psychiatric medication ( anxiolytic, antipsychotic, or antidepressant), what can occur?
ANS: accidental overdose
A nurse is caring for a client who is experiencing alcohol withdraw. Which of the following findings should the nurse expect?
ANS: anxiety and diaphoresis
The nurse is transcribing an order for disulfirian on a patient in alcohol rehabilitation. When planning the time of day to administer this medication, the nurse will document that disulfiram will be given
ANS: at bedtime
Young people should be informed that inhalants can cause?
ANS: brain damage
Positive effects of Cannabis (marijuana)
ANS: glaucoma, asthma, nausea and vomiting as a result of chemotherapy, and as an appetite stimulant.
What is the advantage to using hair analysis to detect drug use?
ANS: hair samples detect drug years up to 1 year
The cause of hangover symptoms have not been pinpointed; however, it is believed to be a result of
ANS: hypoglycemia, dehydration, and the buildup of acetaldehyde acid in the blood
A nurse is teaching about alcohol withdrawal with a client who has a history of alcohol use disorder. Which of the following statements indicates understanding of the teaching?
ANS: i should expect hand tremors to start after i start drinking
Simple intoxication from alcohol usually last
ANS: less than 12 hours
A nurse is assisting with the admission of an acute alcohol patient. Which of the following actions should the nurse take?
ANS: maintain a non judgemental attitude
A nurse is assisting with a court ordered admission of a client to a substance abuse program, the client states " you are all angry with me and wish you could go out and have a drink" the client's response is an example of which of the following defense mechanisms?
ANS: projection
A nurse indicates that a urine sample is needed for screening in a case of DWL. What actions should the nurse implement?
Collection and witnessing by a staff member of the same gender Documented with a chain of custody from signed by all who handle the specimen Keep specimen under secure conditions if temporary storage is necessary
?
Dementia is permanent if the patient progresses to Korsakoff psychosis.
Substance - Related Disorders: Table 62.1
Detachments from surroundings Decreased sensory awareness Illusions of superhuman strength Acute intoxication Flushing, fever, sweating, coma, agitation, confusion, hallucinations, paranoia, violence
What is true regarding hair analysis done on an alcoholic?
Requires sensitive technology Can assess relapse
Patterns and Consequences of Substance Use and Addictive Disorders
SATA could be: Experience erratic and unprovoked mood swing Obtaining and using the substance of choice, starting early in the day, often alone, abstaining more of the substance over time to get the desired effects Work problems or damaged relationships
?
Success is greatest when counseling is used along with smoking sensation aids.
The nurse is assigned to care for a client at risk for alcohol withdraw, the nurse monitors the client knowing that the early signs of withdraw will usually develop within which time after cessation or reduction of alcohol intake?
The signs of early withdrawal from alcohol are agitation and elevated vital signs. These warning signs usually occur 6 to 12 hours after the last drink.
Naltrexone (Revia, Depade)
Used to treat cravings or desires for alcohol once the individual has quit. Blocks receptors in the brain responsible for taking up opiates that result in euphoria. Opioid antagonist.
Rationalization
A defense mechanism in which the addict attempts to justify reason for substance abuse. "Excuse" for addiction. "The drugs my doctors gave me weren't working."
