Download Week 4 - Powerpoint Presentation Notes and more Exams Psychology in PDF only on Docsity!
Week 4 - Powerpoint Presentation
Notes
Per DSM-5 addiction to substances include - ✅alcohol cannabis hallucinogen inhalant opioid sedative/hypnotic stimulant tobacco caffeine* *CAFFEINE cannot have a substance use disorder per DSM- Criteria for substance abuse disorders - ✅cravings to use substance wanting to cut down or stop not managing too taking substance in larger amounts or for longer than you are meant too neglecting other parts of your life because of use continuing to use, even when it causes problems in relationships using substances even when it puts you in danger substance use disorder defined - ✅•Interferes with the ability to fulfill role obligations •Attempts to cut down or control use fail •Intense craving for the substance •Excessive amount of time spent trying to procure the substance or recover from its use •Difficulty with interpersonal relationships / socially isolated •Engages in hazardous activities •Tolerance develops Intoxication - ✅drug does into the body and exerts effects -behavioral -psychological
effects on the body DRUG SPECIFIC withdrawal - ✅exits body after prolonged use DRUG SPECIFIC -sick -dangerous substance induced conditions (brain) - ✅conditions from substances that have effects on brain -mood -anxiety -sleep -sex -psychosis substance use disorders (brain) - ✅use of substance has a real degree of impairment on their life -school -work -home PROBLEM WITH SUBSTANCE USE In order to assess for substance use disorder look at - ✅use -amount -craving -time spent -unable to cut back -problems w/ obligations presence of withdrawal tolerance -effect decreases with increased use Substance intoxication symptoms - ✅reversible syndrome of symptoms following excessive use CNS
relieve everyday stress and tensions of life Phase 2: early alcoholic begins with blackouts now required by person Phase 3: crucial lost control physical dependence clearly evident Phase 4: chronic emotional and physical disintegration more intoxicated than sober effects of alcohol on the body - ✅•Peripheral neuropathy •Alcoholic myopathy •Wernicke's encephalopathy •Korsakoff's psychosis •Alcoholic cardiomyopathy •Esophagitis •Gastritis •Pancreatitis •Alcoholic hepatitis •Cirrhosis of the liver •Leukopenia •Thrombocytopenia •Sexual dysfunction alcohol intoxication occurs at blood level of - ✅100-200 mg/dL alcohol withdrawal occurs within - ✅4-12 hours of cessation reduction in heavy and prolonged alcohol use CONTINUES: 5-7 DAYS
alcohol withdrawal symptoms - ✅coarse tremors: hands tongue eyelids n/v malaise weakness tachycardia sweating hypertension anxiety depressed mood irritability hallucinations illusions headache insomnia PROGRESS too: <1% delirium 2-3 days after cessation -disorientation -hallucination -severe hypertension -dysrhythmias -DEATH fetal alcohol syndrome is - ✅alcohol use during pregnancy (FASD's) FASDs results in - ✅learning difficulties speech delays language delays intellectual delays poor reasoning skills sleep problems sucking problems vision problems hearing problems problems w/ heart-kidneys-bones
-LIFE-THREATENING
Disinhibition - ✅the tendency to transmit messages without considering their consequences Stimulant use disorder - ✅CNS stimulant -amphetamines -synthetic stimulant -non-amphetamine -cocaine -nicotine -caffeine Stimulant effects on the body - ✅•C N S effects •Fight or Flight •Rest and digest •Cardiovascular effects •Pulmonary effects •Tachypnea •Gastrointestinal and renal effects •Sexual functioning Stimulant-induced disorder INTOXICATION - ✅Amphetamine Cocaine -euphoria -impaired judgment -confusion -changes in vital signs (even coma or death, depending on amount consumed) Caffeine -restlessness -insomnia MOST COMMON
250mg Stimulant-induced disorder WITHDRAWAL - ✅Amphetamine
Cocaine Nicotine Caffeine Inhalant use disorder - ✅Aliphatic and aromatic hydrocarbons are found in substances such as fuels, solvents, adhesives, aerosol propellants, and paint thinners. Inhalant effects on the body - ✅CNS effects respiratory effects gi effects renal system effects Inhalant-induced disorder INTOXICATION - ✅•Dizziness, ataxia, muscle weakness •Euphoria, excitation, disinhibition, slurred speech •Nystagmus, blurred or double vision •Psychomotor retardation, hypoactive reflexes •Stupor or coma Opioid use disorder substances - ✅opioids of natural origin opioid derivatives synthetic opiate-like drugs Opioid effects on the body - ✅•C N S effects •Gastrointestinal effects •Cardiovascular effects •Sexual functioning Opioid addiction follows two patterns - ✅•1 The individual who has obtained the drug by prescription from a physician. Abuse and addiction occur when the individual increases the amount and frequency of use, justifying the behavior as symptom treatment. •2 The pattern of behavior associated with addiction to opioids occurs among individuals who use the drugs for recreational purposes and obtain them from illegal sources. Opioid-induced disorders INTOXICATION - ✅Consistent with HALF-LIFE of drug (several hours)
synthetic compounds PATTERN: episodic effects of hallucinogens on the body - ✅physiological: -n/v -chills -pupils dilate -increased b/p -increased pulse -loss of appetite -insomnia -elevated blood sugar (hyperglycemia) -decreased respirations psychological: REASON FOR TAKING THE DRUG -heightened response to color, sounds -distorted vision -sense of slowed time -magnified feelings -paranoia -panic -euphoria -peace -depersonalization -derealization -increased libido hallucinogen-induced disorder INTOXICATION - ✅perceptual alteration depersonalization derealization tachycardia palpitations belligerence assaultiveness seizures coma cannabis use disorder substances - ✅marijuana
hashish cannabis effects on the body - ✅• Cardiovascular
- Respiratory
- Reproductive
- C N S
- Sexual functioning cannabis-induced disorder INTOXICATION - ✅impaired motor coordination euphoria anxiety slowed time impaired judgement red eyes increased appetite dry mouth tachycardia *IMPAIRED MOTOR SKILLS LASTS FOR 8-12 HOURS cannabis-induced disorder WITHDRAWAL - ✅HEAVY USERS -occurs within a week following cessation anger aggression irritable anxiety sleep disturbances decreased appetite depressed mood stomach pain tremors sweating fever chills headache Assessment tools for determining extent of substance use problem - ✅drug history
•Outcome: Verbalizes importance of abstaining from use of substances to maintain optimal wellness. •For the client withdrawing from C N S depressants •Risk for Injury related to C N S agitation •For the client withdrawing from C N S stimulants •Risk for suicide related to intense feelings of lassitude and depression, "crashing," suicidal ideation Outcomes (substance) - ✅• Has not experienced physical injury.
- Has not caused harm to self or others.
- Accepts responsibility for own behavior.
- Acknowledges association between personal problems and use of substance(s).
- Demonstrates more adaptive coping mechanisms that can be used in stressful situations (instead of taking substances).
- Shows no signs or symptoms of infection or malnutrition.
- Exhibits evidence of increased self-worth by attempting new projects without fear of failure and by demonstrating less defensive behavior toward others.
- Verbalizes importance of abstaining from use of substances in order to maintain optimal wellness. Planning/Implementation (substance) - ✅•Risk for injury •Provide safe and supportive environment. •Administer substitution therapy •NO MEDICATION (example) •Denial •Develop trust. •Identify maladaptive behaviors or situations. •Ineffective coping •Establish trust. •Set limits. •Explore options. •Dysfunctional family processes •Review history. •Provide information. •Involve the family. Client/Family education - ✅•Nature of the illness (understand) •Effects of (substance) on the body -Alcohol
-Other C N S depressants -Hallucinogens -Inhalants -Opioids -Cannabinols •Ways in which use of substance affects life Client/Family education / management of illness - ✅•Activities to substitute for (substance) in times of stress •Relaxation technique •Progressive relaxation, tense and relax, deep breathing, autogenics •Problem-solving skills •Essentials of good nutrition •Support services •Financial assistance •Legal assistance •Alcoholics Anonymous (or other support group specific to another substance) •One-to-one support person chemically impaired nurse signs - ✅•Increase in "wasting" of drugs, higher incidences of incorrect narcotic counts, and a higher record of signing out drugs for other nurses may be present. •Poor concentration, difficulty meeting deadlines, inappropriate responses, and poor memory or recall •Problems with relationships •Irritability, tendency to isolate, elaborate excuses for behavior •Unkempt appearance, impaired motor coordination, slurred speech, flushed face •Patient complaints of inadequate pain control, discrepancies in documentation chemically impaired nurse state board response - ✅•May deny, suspend, or revoke a license based on a report of chemical abuse by a nurse •Diversionary laws allow impaired nurses to avoid disciplinary action by agreeing to seek treatment. During the suspension period •Successful completion of an inpatient, outpatient, group, or individual counseling treatment program •Evidence of regular attendance at nurse support groups or 12-step program •Random negative drug screens •Employment or volunteer activities •Peer assistance programs serve to assist impaired nurses to: •Recognize their impairment
stage 4: reintegration -self-acceptance -willingness to change when codependents relinquish power over others -reclaim personal power they possess alcoholics anonymous is a - ✅major self-help organization for treatment of alcoholism -peer support -acceptance -understanding from others who have experienced the same problem 12-Step program ONLY CURE: total abstinence, NEVER return to social drinking treatment modalities for substance-related disorders - ✅support groups (AA/NA) counseling group therapy pharmacotherapy for alcoholism - ✅disulfiram (Antabuse) alcohol withdrawal: -benzodiazepines -anticonvulsant -multivitamins -thiamine psychopharmacology for substance intoxication and substance withdrawal - ✅naltrexone nalmefene ssri acamprosate OPIOIDS: naloxone naltrexone nalmefene buprenorphine methadone clonidine
DEPRESSANTS:
phenobarbital long-acting benzodiazepines STIMULANTS: minor tranquilizers major tranquilizers anticonvulsants antidepressants HALLUCINOGENS/CANNABINOLS: benzodiazepines antipsychotics gambling disorder - ✅persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress. The impulse to gamble often intensifies when the individual is under stress, and many describe a physical sensation of restlessness and anticipation that can only be relieved by placing a bet gambling disorder usually begins - ✅adolescence, although compulsive behaviors rarely occur before young adulthood chronic course (waxing/weaning) gambling disorder interferes with - ✅interpersonal relationships social functioning academia functioning occupational functioning predisposing factors to gambling disorder - ✅biological -genetic family -physiological neurotransmitter abnormal psychosocial -loss of parent before 15 YO -inappropriate parental discipline
-first 3 months after trauma *CAN BE A DELAY OF SEVERAL MONTHS OR YEARS PTSD characteristic symptoms include - ✅•Reexperiencing the traumatic event •A sustained high level of anxiety or arousal •A general numbing of responsiveness •Intrusive recollections or nightmares •Amnesia to certain aspects of the trauma •Depression; survivor's guilt •Substance abuse •Anger and aggression •Relationship problems Difference between PTSD and ASD is that - ✅ASD symptoms are time limited, up to 1 month following trauma Acute stress disorder (ASD) symptoms (IMPORTANT) - ✅Begins: -up to 1 month following trauma *NOTE: symptoms last longer than 1 month, diagnosis is PTSD trauma-related disorders predisposing factors - ✅psychosocial theory -variables traumatic experience individual recovery environment *why some develop PTSD and others do not learning theory -negative reinforcement -avoidance behaviors -psychic numbing cognitive therapy -vulnerable when fundamental belief system is invalidated by experienced trauma and it cannot be comprehended, leaving a sense of helplessness and hopelessness
biological aspects -symptoms related to production of endogenous opioid peptides that are produced by arousal -STRESSOR terminates, individual may experience opioid withdrawal which bear a strong resemblance to PTSD -disregulation of the opioid, GLUTAMATERGIC NORADRENERGIC, SEROTONERGIC, and NEUROENDOCRINE pathways Specific characteristics relating to trauma as an individual long-term response - ✅• Severity and duration of the stressor
- Extent of anticipatory preparation for the event
- Exposure to death
- Numbers affected by life threat
- Amount of control over recurrence
- Location where the trauma was experienced (for example, familiar surroundings, at home, in a foreign country) •Variables that are considered important in determining an individual's response to trauma include:
- Degree of ego-strength
- Effectiveness of coping resources
- Presence of preexisting psychopathology
- Outcomes of previous experiences with stress/trauma
- Behavioral tendencies (temperament)
- Current psychosocial developmental stage
- Demographic factors (for example, age, socioeconomic status, education) trauma-informed care generally describes - ✅philosophical approach that values awareness and understanding of trauma when assessing, planning, and implementing care Nursing dX: trauma-related disorders - ✅•Post-trauma syndrome related to distressing event considered to be outside the range of usual human experience, evidenced by flashbacks, intrusive recollections, nightmares, psychological numbness related to the event, dissociation, or amnesia.
- Complicated grieving related to loss of self as perceived before the trauma or other actual or perceived losses incurred during or after the event evidenced by irritability and explosiveness, self-destructiveness, substance abuse, verbalization of survival guilt, or guilt about behavior required for survival. outcome criteria for trauma-related disorders -
