Substance-Related Disorders

  1. What is substance abuse?
    Repeated use of a drug while knowing the negative consequences
  2. What is substance dependence?
    Poor pattern of substance use leading to impairment and loss of control
  3. Substance dependence common symptoms

    Withdrawal symptoms
  4. If a patient is intoxicated upon admission try to get ______ and when the patient sobers up, try to get ______ again.
    Informed consent

    Informed consent
  5. Is addiction a disease?

    It's pathological, so the patient can't help it
  6. Why aren't we all addicted?

    Routine family gatherings


    Genetic risk factor

    No trauma or psych disorders
  7. Substances of Abuse:
    CNS Depressants
    • Alcohol
    • Barbiturates
    • Opioids
  8. Substances of Abuse:
    CNS Stimulants
    • Amphetamines
    • Nicotine
    • Caffeine
    • Cocaine
  9. Substances of Abuse:
    • Hallucinogens
    • Inhalants
    • Marijuana
    • Sedatives, Hypnotics, Anxiolytics
  10. Chronic alcohol use can also lead to

    • Esophagitis
    • (Typical to see JVD)

    • Pancreatitis
    • (Very painful)

    • Wernicke - temporary
    • Korsakoff - permanent
    • (Thiamin deficient)
  11. Most common problems with alcohol use is
    Hepatitis and Cirrhosis
  12. Alcohol withdrawal:

    6-12 hours after last drink

    • Tremors of hands, tongue, eyelids
    • N&V
    • Tachycardia
    • Diaphoresis
    • Irritability
    • Headache
    • Insomnia
  13. Delirium Tremens:

    Major withdrawal causing disturbed consciousness and altered mental status

    48-72 hours

    • Hallucinations (see/feel bugs)
    • Seizures

    Lasts 1 week-1month

    • Benzodiazepines
    • Anticonvulsants
    • Vitamins
    • Thiamine (IM)
  14. The nurse is aware that the defense mechanism commonly used by clients who are alcoholics is
    • Denial
    • Rationalization
  15. A 20y/o male falls off a roof and fractures his right femur and left tibia. The client reveals a history of substance dependence. a primary concern for the nurse caring for this patient would be to
    Realize the client will need more pain medication than the nonabuse
  16. A 65y/o male is admitted to a mental health facility with a diagnosis of substance-induced persisting dementia resulting from chronic alcoholism. When conducting the interview, the nurse determines the client is using confabulation. This is due to
    Marked memory loss
  17. The nurse's plan of care for a client with substance-induced persisting dementia resulting from alcoholism should take into consideration that this disorder is thought to be caused by
    A deficiency of thiamine in the diet
  18. When planning for a client who has a long history of heavy drinking, the nurse must be aware that symptoms of withdrawal usually occur
    8-12 hours after the last drink
  19. A client with a long history of heavy drinking is brought to a psychiatric facility in a stupor. On the day after admission the client is confused, disoriented and delusional. The client may be developing alcoholic
    Withdrawal delirium
  20. Opioid effects on the body:

    Pupil constriction, respiratory depression, sedation, mood changes

    Constipation, slow peristalsis


    • Sexual dysfunction
    • Euphoria
  21. Opioid withdrawal timelines:

    8-12 hours, lasts 4-5 days

    6-24 hours, lasts 5-7 days

    1-3 days, lasts 2 weeks

    (Not life-threatening, just really uncomfortable)
  22. Opiate overdose:

    What is the antidote?
    Why must you monitor VS every 15 minutes?
    Narcan (Naloxone)

    To make sure the patient doesn't go into respiratory depression
  23. Nicotine replacment therapy
    • Varenicline (Chantix)
    • (Has many side effects)

    Buproprian (Zyban)
  24. Hallucinogen S/S:
    • Dilated pupils
    • Diaphoresis
    • Sleeplessness
    • Dry mouth
    • Tremors
    • Suppress high cerebral function
    • Synesthesia ("Hear colors, smell sounds")
  25. Benzodiazepines must be slowly tapered off because
    If not then patient will be at high risk of seizures and diaphoresis
  26. CAGE Questionnaire
    C - Have you ever felt you should CUT down on your drinking?

    A - Have people ANNOYED you by criticizing your drinking?

    G - Have you ever felt bad or GUILTY about your drinking?

    E - Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover? (EYE opener)
Card Set
Substance-Related Disorders