TX Substance use disorder

  1. nx dx/outcome indentification
    ineffective coping
    • r/t denial
    • outcome: client will be able to demonstrate more adaptive coping mechanism that can be used in stressful situations- not using
  2. nx dx/outcome indentification
    imbalanced nutrition
    • less than body requirements/fluid volune deficit r/t drinking or taking drugs instead of eating
    • outcome- client willbe free from s/s of malnutrition/dehydration
  3. nx dx/outcome indentification
    risk for infection
    • r/t malnutrition and altered immune condition
    • outcome- shows no s/s of infection
  4. nx dx/outcome indentification
    chronic low self esteem
    • r/t lack of positive feedback
    • outcomes- exhibits evidence of incr self worth by attempting new projects without fear of failure and by demonstrating less defensive behavior toward others
  5. nx dx/outcome indentification
    deficient knowledge (effects on substance abuse on body)
    • r/t denial of problems with substances evidence by abuse of substances
    • outcome- verbalize importance of abstaining from use of substances to maintain optimal wellness
  6. nx dx/outcome indentification
    risk for injury
    • from the client withdrawing from cns deppressants- alcohol, sedative, benzo barbs
    • risk for injury r/t to cns agitation
    • for the pt withdrawing from cns stimulants- caffeine, nicotine, cocaine, addrell
    • risk for suicide r/t to intense feelings of lassitude and depression, crashing, SI
  7. Planning/implemtation
    • provide safe supportive environment
    • adminster substitution therapy
  8. Planning/implemtation
    intermediate care
    • provide explanation of physical symptoms
    • promote understanding and identify causes of substance dependency
    • help pt accept use of substance as a problem
    • provide education and assistance to pt and fam
  9. Planning/implemtation
    • encourage cont participation- long term treatment
    • promote participation in outpatient support system
    • assist pt to identify alternative sources of satisfaction
    • provide support for health promotion and maintenance
  10. Nursing process: evaluation
    evaluation involves reassessment to determine whether the nursing interventions have been effective in achieving the intended goals of care
  11. the chemically impaired nurse
    • it is est. that 10-15% of nurses sugger from the disease of chemical dependency
    • alcohol is the most widely abused drug, followed closely by narcotics
  12. the chemically impaired nurse
    • clues for recognizing this in nurses varies depending on the substance
    • high absent from work may be present when the source is outside of work
    • or person may rarely miss work if substance is there
  13. the chemically impaired nurse
    clues 2
    • incr wasting of drugs, higher incidences of incorrect narcotic counts, and a higher record of signing out drugs than other nurses may be present
    • poor concentration, difficulty meeting deadlines, inapproriate responses and poor memory or recall
    • problems with relationships
    • irriablity tendency to isolate, elaborate excuses for behavior
  14. the chemically impaired nurse
    how they act
    • unkempt apperance, impaired motor coordination, slurred speech, flushed face, disorganized
    • pt compliants of inadequate pain control, discrepancies in documentation
  15. the chemically impaired nurse
    state board response
    • may deny, suspend, revoke a license based on report of chemical abuse by a nurse
    • diversionary laws allow impaired nurses to avoid disciplinary action by agreeing to seek tx
  16. the chemically impaired nurse
    during the suspension period
    • succesful completion of inpatient, outpatient, group or individual counseling tx program
    • some run by state board of nursing
  17. the chemically impaired nurse
    what they have to do
    • evidence of regular attendance at nurse support groups or 12 step program
    • random negavtive drug screen
    • employment or volunteer activities
  18. the chemically impaired nurse
    peer assistance programs serve to assist impaired nurse
    • recognize their impairment
    • obtain necessary tx
    • regain accountablity within profession
  19. codependency
    defined by dysfunctional behaviors that are evident among members of the family of a chemically dependent person, or among family members who harbor secrets of physical or emotional abuse other cruelties, or pathological conditions
  20. codependency
    about this type of person
    • codependent people sacrifice their own needs for the fulfillment of others to achieve a sense of control
    • derives self worth from others
    • feels responsible for the happiness of others
    • commonly denies that problems exist
  21. codependency
    keeps feelings in control and often releases anxiety in the form of stress related illness or compulsive behaviors such as eating, spending, working or use of substance
  22. codependency
    reason why
    • may have experienced abuse or emotional neglect as a child
    • outwardly focused on others and know very little about how to direct their lives from their own sense of self
  23. The codependent nurse
    • caretaking
    • perfectionism
    • denial
    • poor communication
  24. Treating codependence
    recovery process
    • survival stage- letting go
    • re-identification- denial breaks and gets a true sense of self
    • core issues stage- facts on manage, cant force/will relationship
    • reintegration stage- self acceptance and chx willingness
  25. Treatment modalities for substance-related disorders
    • a major self-help organization for the treatment of alcoholism
    • based on the concept of
    • - peer support
    • - acceptance
    • - understanding from others who have experienced the same problems
  26. Treatment modalities for substance-related disorders
    AA 2
    • the 12 steps that embody the philosophy of AA provide specific guidelines on how to attain and maintain sobriety
    • total abstinence is promoted as the only cure; the persona can never safely return to social drinking
  27. Treatment modalities for substance-related disorders
    • various support groups patterned after AA but for individuals with problems with other substances
    • counseling
    • group therapy
Card Set
TX Substance use disorder