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Topic 10 study materials

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Behavioral Health Nursing (NSG-322)

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Behavioral HealthNSG-322

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  1. alcohol is often... •used in combination with other substances

  2. marijuana •Recreational use •Legalized in some states •Medicinal use •Legalized in several states •Use remains federally prohibited

  3. nicotine •Historic trends continue: •cigarettes

    • pipes •chewing tobacco •Newer trend: •e-Cigarettes ("vaping")
  4. opioids •Includes prescription pain relievers & heroin •Opioid overdose is at epidemic levels (A leading cause of death in the U.) •Women dying of heroin overdose has tripled

  5. prescription abuse

•Opioids •Sedatives (e., benzodiazepines) •Stimulants

  1. medications that fall under the opi- oid class

•hydrocodone (e., Vicodin), •oxycodone (e., OxyContin, Percocet), •Hydromorphone (Dilaudid) •morphine (e., Kadian, Avinza), •codeine, and related drugs.

  1. Dependence/Ad- diction and changes in the brain

The most important structural or architectural change takes place in the circuitry of the brain — particularly in the wiring of the reward pathway

  1. withdrawal symptoms may occur if drug use is suddenly

restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps ("cold turkey"), and involuntary leg movements.

Study online at quizlet/_9jaavh reduced or stopped are...

  1. the 4 Cs of addic- tion

•Compulsive behavior (finding & taking the substance) •Cravings •Chronic, relapsing brain disorder •Cognitive impairment

  1. How do drugs work in the brain to produce plea- sure?

Most drugs of abuse directly or indirectly target the brain's reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that regulate movement, emotion, cognition, motiva- tion, and feelings of pleasure. The overstimulation of this system, which rewards our natural behaviors, produces the euphoric effects sought by people who abuse drugs and teaches them to repeat the behavior.

  1. Alcohol and oth- er CNS depres- sants act on what NT

GABA

  1. tolerance can lead to

dependence, then addiction, then overdose

  1. Client -Centered Care:Assess- ment for Substance Abuse

1 presenting signs 2 for withdrawal 3 for overdose 4 for self-harm potential 5 physiologic response 6 individual's interest in taking action 7 knowledge of community resources

  1. Since the brain is not fully de- veloped until the mid-20s...

early drug abuse negatively impacts brain development.

  1. -Reporting an impaired colleague is a peer responsibility (mandated reporter)

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  1. Decline in lean muscle mass and increased fatty tissue contribute to...

increased blood alcohol levels (BALs).

  1. •Changes in the response to alco- hol include: (old- er adults)

•Headaches •Reduction in mental abilities •Memory losses or lapses •Feelings of malaise instead of well-being

  1. older adults have decreased liver enzymes which

decrease the ability or break down alcohol, making higher BAL than in younger people

  1. alcohol should not be mixed with

Antidepressants and tranquilizers because they further depress the CNS

  1. Toxicity of other drugs (e., acetaminophen (Tylenol)) is enhanced by

alcohol-associated malnutrition.

  1. Physiologic Ef- fects of Alcohol

•Brain Function •Fetal Alcohol Syndrome (FAS) •Alcoholic Cardiomyopathy •Arrhythmias •Hypertension

  1. Alcohol can cause your neu- rotransmitters to relay information too slowly, so you feel..

extremely drowsy

  1. Alcohol related disruptions to

depression, agitation, memory loss, and even seizures.

Study online at quizlet/_9jaavh the neurotrans- mitter balance also can trigger mood and behav- ioral changes, in- cluding...

  1. what NT is sus- ceptible to even small amounts of alcohol, and what does it affect

glutamate -glutamate affects memory

  1. what NT does al- cohol affect that sparks feeling of relaxation and euphoria

serotonin

  1. alcohol damages liver function which can lead to

hepatic encephalopathy

  1. s/s of hepatic en- cephalopathy
  • Sleep disturbances
  • Mood and personality changes
  • Anxiety
  • Depression
  • Shortened attention span
  • Coordination problems, including asterixis, which results in hand shaking or flapping
  • Coma
  • Death
  1. Doctors can help treat hepat- ic encephalopa- thy with

compounds that lower blood ammonia concentrations and with devices that help remove harmful toxins from the blood.

  1. Fetal Alcohol Syndromes

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  1. •Consequence of untreated Wer- nicke's en- cephalopathy is

Korsakoff's Psychosis

  1. late effects of al- coholism

•Cirrhosis •Jaundice •Esophageal varices •Ascites •Hepatomegaly •Splenomegaly •Edema •Spider angiomas •Anemia/Thrombocytopenia •Coagulation disorders •Peripheral neuropathy

  1. •thiamine (B1) deficiency is caused by

•Wernicke-Korsakoff's syndrome

  1. treatment for thi- amine (B1) defi- ciency

•thiamine for B1 replacement, magnesium sulfate, folic acid & multivitamin

  1. how long does it take for the liver to detox 1oz of al- cohol

1 hour

  1. Blood alcohol level (BAL):

•determines level of intoxication and tolerance

  1. Intoxication

  2. BAL of 0% (1- drinks)

changes in mood and behavior; impaired judgment

  1. BAL of 0% (5- drinks)

legal level of intoxication in most states. clumsiness in voluntary motor activity

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  1. BAL of 0% (10-12 drinks)

depressed function of entire motor area of the brain, caus- ing staggering and ataxia; emotional liability

  1. BAL of 0% (15-19 drinks)

confusion, stupor

  1. BAL of 0% (20-24 drinks)

coma

  1. BAL of 0% (25-30 drinks)

death caused by respiratory depression

  1. alcohol with- drawal stages: mild

•Anxiety •Tremors (feeling 'shaky') •Insomnia •Headache •Palpitations •Gastrointestinal disturbances (cramping) •Orientation remains intact

  1. alcohol with- drawal stages: moderate/severe

•Diaphoresis •Elevated systolic blood pressure •Tachypnea •Tachycardia •Confusion •Mild hyperthermia •Hallucinations (visual, tactile, and or auditory) •Orientation remains intact

  1. alcohol with- drawal stages: delirium tremens (DTs)

•Disorientation to time, place, and person •Impaired attention •Agitation •Hallucinations (visual, tactile, and or auditory) •Potential seizures

  1. alcohol with- drawal peaks within

24-48 hours after last drink

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  1. Clinical Insti- tute Withdraw- al Assessment (CIWA-AR) is used for..

Used to assess the need for alcohol detoxification.

  1. alcohol detox s/s •Nausea/vomiting •Tremors •Anxiety •Agitation •Paroxysmal Sweats •Orientation •Tactile Disturbances •Auditory Disturbances •Visual Disturbances •Headaches

  2. medications for alcohol use dis- order

•benzodiazepines •anticonvulsants •beta-blockers •magnesium, thiamine (vitamin B1), folic acid, and multi- vitamins

  1. vitamins used for alcohol use dis- order

magnesium, thiamine (vitamin B1), folic acid, and multivi- tamins

  1. what are the first like drugs fro sedation and seizure preven- tion/control

benzodiazepines

  1. benzodiazepine examples

•chlordiazepoxide •lorazepam •diazepam

  1. diazepam has.. anticonvulsive qualities, Not metabolized in the liver*

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  1. diazepam needs to be

•Gradually taper and discontinue benzodiazepines once detox is complete

  1. •Other drugs used for seizure preven- tion/control

•carbamazepine •valproic acid •magnesium

  1. Naltrexone •Reduces or eliminates alcohol craving

  2. Acamprosate •Reduces alcohol craving •Reduces unpleasant symptoms of abstinence (anxiety, tension, and dysphoria) •Prolongs withdrawal symptoms

  3. benefits of Acam- prosate are seen after

30-90 days

  1. disulfiram if you drink taking this, you will get sick (that is the point of the medicaton) •Alcohol ingestion results in unpleasant physical effects (nausea, vomiting, headache, and flushing)

  2. individual needs to be alcohol free for how many days inorder to take disulifram

•Must be alcohol-free for at least 14 days to avoid this reaction when starting (or restarting) disulfiram

  1. treatment op- tions for alcohol use disorder

•Inpatient •Partial Hospitalization •Residential Treatment •Outpatient •Self-Help •Support Groups •12 Step Programs (self-help groups)

  1. Long-Term Resi- dential Treatment

Lengths of stay between 6 and 12 months in a non-hospi- tal setting.

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Topic 10 study materials

Course: Behavioral Health Nursing (NSG-322)

77 Documents
Students shared 77 documents in this course
Was this document helpful?
322: Topic 10
Study online at https://quizlet.com/_9jaavh
1. alcohol is often... •used in combination with other substances
2. marijuana •Recreational use
•Legalized in some states
•Medicinal use
•Legalized in several states
•Use remains federally prohibited
3. nicotine •Historic trends continue:
•cigarettes
• pipes
•chewing tobacco
•Newer trend:
•e-Cigarettes ("vaping")
4. opioids •Includes prescription pain relievers & heroin
•Opioid overdose is at epidemic levels (A leading cause of
death in the U.S.)
•Women dying of heroin overdose has tripled
5. prescription
abuse
•Opioids
•Sedatives (e.g., benzodiazepines)
•Stimulants
6. medications that
fall under the opi-
oid class
•hydrocodone (e.g., Vicodin),
•oxycodone (e.g., OxyContin, Percocet),
•Hydromorphone (Dilaudid)
•morphine (e.g., Kadian, Avinza),
•codeine, and related drugs.
7. Dependence/Ad-
diction and
changes in the
brain
The most important structural or architectural change
takes place in the circuitry of the brain — particularly in
the wiring of the reward pathway
8. withdrawal
symptoms may
occur if drug use
is suddenly
restlessness, muscle and bone pain, insomnia, diarrhea,
vomiting, cold flashes with goose bumps ("cold turkey"),
and involuntary leg movements.
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