Substance Abuse Disorders: Identification, Treatment, and Management, Exams of Nursing

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Nurs 300-Module 1 Questions With Complete Solutions What is the addictive substance that is most used/misused in America Alcohol Addiction definition Chronic, relapsing brain disease characterized by compulsive drug seeking behavior What is addiction motivated by craving, long-lasing changings in the brain despite harmful consequences Substance Abuse Disorder continued use of substance despite significant symptoms related to substance of use Tolerance The need for larger amounts to get the same effect Cross tolerance Tolerance for one drug while also building up a tolerance for another drug in the same or chemically similiar class of drugs intoxication

disturbances in the level of consciousness, cognition, perception, affect, behavior, or other psychophysiological functions and responses as a result of alcohol or psychoactive substance usage Blackouts amnesia for the vents of any parts of a drinking episode without loss of consciousness Withdrawal occur after an extended period of continued use and signify physical dependence Flashbacks transitory recurrences of a perceptual disturbance caused by earlier hallucinogenic drug use Co-occurring disease coexistence of SUD's along with one or more additional mental disorders Codependency dysfunctional helping relationship where one person supports or enables another person's compulsive/addictive behavior How is cost a consequence to substance abuse addicts can spend 100-400 a day on materials How do genetics play a role in addiction

genetics account for 40%-60% of a person's vulnerability to addiction What are some family dynamics for substance abuse unstable environment, childhood trauma, neglect, divorce, sexual assault how is coping styles a psychological factor for substance abuse individuals are looking for a emotional escape What are some social/environmental factors for substance abuse culture you are in, peer behaviors, social attitudes How is the brain connected to substance abuse the limbic system (reward circuit) controls the brain structures that control our pleasure feelings What does overstimulating the limbic system do creates a euphoric effect and then our brain and body constantly try to seek for the first time "feeling" How does having AUD affect children it is 3-4x more likely to occur in children What is the biggest risk in regards to alcohol use disorder it can cause respiratory depression What is Alcohol abuse disorder

CNS Depressant: relaxation and loss of inhibitions Effects of Alcohol abuse disorder Slurred speech, unsteady gait, lack of coordination, impaired memory/judgement Long term effects of Alcohol use disorder Wernicke's encephalopathy, problems with decision making, memory and learning Wernicke's encephalopathy Acts drunk but has no alcohol in the system alcohol causes B vitamin deficiency causing wet brain no cure/treatment Screenings for alcohol use disorder CAGE (Cut down, Annoyed, Guilty, Eye opener) AUDIT (Alcohol Use Disorder Identification Test) What can happen if you don't get treated for alcohol withdrawal Delirium, seizures, and hallucinations -can lead to potential death What is the onset of alcohol withdrawal -When is the peak 4-12 for onset 48-72 hours for peak effect

Symptoms of Alcohol withdrawal Course hand tremors, anxiety/agitation, tachycardia, high fever What do you treat alcohol withdrawal with Benzodiazepines Ativan and librium Basic information about CIWA Scale It is objective (means we observe it) Ranges for CIWA scale below 8-Mild 8-15=Moderate 15+=severe What should you do once you administer ativan Assess your patient every hour What are the most common opiates Herion and oxycodone Other opiates Morphine, hydrocodone, fentanyl, codeine Signs and symptoms of opiate use euphoria, lethargy, impaired judgement, drowsiness, slurred speech

Opiate overdose symptoms pinpoint pupils, respiratory distress, unconsciousness *nodding off Opiate withdrawal symptoms nausea, vomiting, anxiety, muscle aches, and abdominal cramping Medication to give for opiate withdrawal ibuprofen, immodium, zofran, gabavistaril What is important to watch out for with stimulant withdrawal suicidal risks Examples of stimulants cocaine, crack, amphetamines, methamphetamines What can high doses of stimulants cause seizures, heart failure, strokes What is the goal for substance abuse treatment Facilitate a change in behavior: stopping compulsive drug seeking and use Why do we need to have teaching for the patient AND the family sometimes the family is sicker than the patient due to always worrying and caring for patient

How would you treat for substance abuse disorders treat like a medical illness that is chronic and progressive What is Disulfrim (Antabuse) administered for helps deter clients away from drinking *pay attention to products that contain alcohol Buprenorphine/naloxone (Suboxone) administered for Decrease cravings and for opiate maintenance What is Naltrexone (Vivitrol) administered for once-monthly as an injection to reduce cravings for alcohol and to block effects of opioids Chose the most appropriately written expected outcome. The client will: A. express fewer signs of discomfort B. walk 10 feet by post-op day 2 C. eat good food for lunch D. describe feelings every shift B. walk 10 feet by post-op day 2 The nurse informs a client with pyelonephritis that the organisms that cause this disorder most commonly reach the kidneys through: A. the bloodstream B. the lymphatic system C. a descending infection

D. an ascending infection The nurse teaches a female client who has frequent UTIs that she should: A. take a tub or bubble bath daily B. urinate before and after sexual intercourse C. take prophylactic ATBs (antibiotics) -- starts killing good bacteria, will increase your risk for an infection and you become antibiotic resistant D. restrict fluid intake to prevent void B. urinate before and after sexual intercourse Which is a physician initiated intervention? A. the nurse will administer soap suds enemas until bowels run clear B. the nurse will assess color, consistency, odor, and amount of each BM C. the nurse will assist the client with ambulation to the nurses' station every shift D. the nurse will teach the family management of a colostomy A. the nurse will administer soap suds enemas until bowels run clear True or false: qualitative research is the study of phenomena that are difficult to quantify or categorize -- listening to people's stories true

True or false: an updated nursing textbook is the best source of the most recent scientific literature in nursing false Which type of study provides the best source of scientific evidence? A. case control study B. controlled trial without randomization C. single randomized controlled trial D. systematic review or meta-analysis D. systematic review or meta-analysis The process of obtaining, organizing, and conveying client health information to others in print or electronic format is referred to as a. narration. b. documentation. c. care coordination. d. order entry. B. documentation One major advantage of an electronic health information technology system is

a. lack of integration. b. accessibility of health records. c. it is not easily transferable. d. it consists of imaging files that allow for delayed access. B. accessibility of health records Which of the following is a disadvantage of computerized charting? a. Ability to aggregate data b. Improved access to health record c. Standardized charting d. Preset activities that can be coded C. standardized charting The nurse is caring for a client who is recovering from an appendectomy. Which of the following coding systems should the nurse use for documenting changing of the client's postoperative abdominal dressing?

a. Nursing outcomes classification (NOC) b. Diagnostic-related groups c. Nursing intervention classification d. North American Nursing Diagnosis (NANDA) C. nursing intervention classification The nursing diagnosis for a client is immobility related to a stroke. Which classification system can be readily used with this diagnosis? a. Omaha system of client problems b. Clinical pathways c. Nursing intervention classification d. International classification of disease (ICD) C. nursing intervention classification A client is 3 days postoperative from gallbladder surgery secondary to gallstones. Domain: Physiological. Class: Fluid and electrolyte balance. Activity: Check intravenous fluid rate intake every hour. Which of the following nursing coding systems is represented in this situation?

a. North American Nursing Diagnosis (NANDA) b. Nursing intervention classification c. Nursing outcome classification d. Omaha system of client problems B. nursing intervention classification All of the following are true about electronic records except a. they are portable. b. they are less durable than paper charting. c. they are easily transferable. d. they are more durable than paper charting. B. they are less durable than paper charting Review the charting sample and determine which documentation error occurred. 1000: Hygienic care given 1100: Complaint of leg pain

1300: Appetite good, resting comfortably a. Recording on the wrong chart b. Failure to document an intervention c. Failure to document a discontinued medication d. Failure to record outcome of an intervention B. failure to document an intervention Which of the following is a computer charting system related to predicting client outcomes in home health care? a. EHR b. OASIS c. NANDA d. HIPAA B. OASIS Which classification system is a comprehensive practice, documentation, and information management tool?

a. NANDA b. NIC c. NOC d. Omaha system D. Omaha system When documenting client care, the nurse recognizes that which of the following is true about documentation of care? a. Every nurse should anticipate having clients' records subpoenaed at some time during his or her nursing career. b. There is a need for quicker documentation that does not reflect the nursing process. c. The legal assumption is that care was given even if it is not documented. d. Any method of documentation that provides comprehensive, factual information is legally unacceptable. A. Every nurse should anticipate having clients' records subpoenaed at some time during his or her nursing career

A client slipped and fell in the bathroom. When filling out an incident report, the nurse should a. record complete, pertinent health information. b. write about the incident report in the client record. c. store the incident report in the client record. d. make untimely entries. A. record complete, pertinent health information