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Mental Health 2
Care of the Chemically Impaired Part 2
| Question | Answer |
|---|---|
| When the impaired nurse is on duty there may be more complaints of what from patients? | Increased or unreliever pain, or inability to sleep |
| Intervention for a nurse with a chemical dependency problem is the responsibility of | the nurse manager, and the nursing administratiors |
| When nurses deny or rationalize the behavior of an impaired colleague it is called | enabling |
| What do we assess for in the patient who is chemically impaired? | Severe or major withdrawal syndrome;overdose to a drug or alcohol that warrants immediate attention;suicidal thought or self-destructive behaviors;physical complications;interests in changing;knowledge of resources. |
| What would the goal of a ND of Fluid Balance be for the patient going through withdrawal? | The patient's BP will not be compromised. |
| What would the goal of aND of Neurological Status: consciousness be for the patient going through withdrawal? | The patient will have no seizure activity. |
| What would the goal of a ND of Distorted Thought Self-control be for the patient going through withdrawal | The patient will consistently describe content of hallucinations. |
| What would the goal of a ND of Risk Control: Alcohol Use be for the patient going through initial and acutal drug treatment be? | The patient will consistentl demonstrate a commitment to alcohol use control strategies. |
| Drug Use be for the patient going through initial and acutal drug treatment be? | The patient will consistently demonstrate acknowledgment of personal consequences associated with drug misuse. |
| What would the goal of a ND of Substance Addiction Consequences be for the patient going through initial and acutal drug treatment be? | Client will demonstrate no difficulty supporting self financially. |
| What would the goal of a ND of Knowledge: Substance Abuse Control be for the patient going through health maintenance be? | The patient will describe actions to prevent and manage relapses in substance use. |
| What would the goal of a ND of Family Coping be for the patient going through health maintenance be? | Patient's family will consistently demonstrate care for needs of all family members. |
| What is the aim of treatment for the addict? | Self responsibility, not compliance. |
| At all levels of practice, the nurse can play an important role in the intervention process by | Recognizing the signs of substance abuse in both the client and the family and by being familiar with the resources available to help with the problem. |
| What does the use of therapeutic leverage do for a substance abuser? | Maes abstinence and sobriety worthwhile for them. |
| ______ prevention of HIV infection in the drug using population is facilitated by needle exchange programs. | primary |
| When using the acronym FRAMES in brief interventions, what does the letter "F" stand for? | Feedback of personal risk. |
| When using the acronym FRAMES in brief interventions, what does the letter "R" stand for? | Responsibility of the patient (personal control) |
| When using the acronym FRAMES in brief interventions, what does the letter "A" stand for? | Advice to change |
| When using the acronym FRAMES in brief interventions, what does the letter "M" stand for? | Menu of ways to reduce substance use (options) |
| When using the acronym FRAMES in brief interventions, what does the letter "E" stand for? | Empathetic counseling |
| When using the acronym FRAMES in brief interventions, what does the letter "S" stand for? | Selfefficacy or optimism of the patient. |
| What are the case manager's goals and responsiblities for the substance-abusing client? | Idendify presenting problems; develop an individualized plan, including client goals and a plan to reach those goals; link clients with various treatment providers; serve as the client's advocate when needed. |
| The substance use disorder and psychiatric disorder are both considered _______ and need simultaneous treatment when dealing with dual diagnosis principles. | primary |
| The therapeutic process of _______ involves teaching the client to identify the physical and emotional changes that are ocuring in the here and now. | psychotherapy |
| General strategies for relapse prevention are: | cognitive and behavioral: recognizing and learning how to avoid or cope with threats to recovery;changing lifestyle; learning how to participate fully in society without drugs; and securing help from other people, or social support. |
| The most effective treatment modality for all addicitions has been the | 12-step program |
| What three basic concepts are fundamental to all 12-step programs? | Individuals are powerless over their addiction and their lives are unmanagealbe; even though not resposible for their disease, they are responsible for their recovery; they must face their problems and their feelings. |
| ______ teatment programs are best suited for individuals who have a long history of antisocial behavior. | Residential |
| The goal of treatment in ______ programs is to effect a change in lifestyle, including abstinence, development of social skills, and elimination of antisocial behavior. | residential |
| An agent used for narcotic addiction that is sometimes used in the treatment of alcoholism. | Naltrexone |
| _______ works by blocking opiate receptors, thereby interfering with the mechanism of reinforcement and reducing or eliminating the alcohol craving. | Naltrexone |
| A second medication used to treat aloholism that was approved by the FDA in 2004. | Acamprosate |
| What drugs are used to treat alcohol withdrawal delerium? | Benzodiazapines, thiamine, magnesium sulfate, anticonvulsants, folic acid, and multivitamins. |
| Why is magnesium sulfate given to a patient with alcohol withdrawal delirium? | helps reduce postwithdrawal seizures |
| This medication is used with motivated client who've shown the ability to stay sober. It works on the conditioning principle of inhibiting impulsive drinking; the client tries to avoid the unpleasant effect caused by the alcohol-__________ reaction. | Disulfiram (Antabuse) |
| A synthetic opiate that blocks the craving for and effects of heroin. | Methadone (Dolophine) |
| _______ has to be taken every day, is highly addictive, and when stopped produced withdrawal. | methadone |
| The only medication currently approved for the pregnant opioid addict. | methadone |
| _______ has to be taken every day in contrast to ______ which only has to be take every3 days. | Methadone, LAAM |
| A relatively pure antagonist that blocks the euphoric effects of opioids. It has low toxicity and few side effects. | Naltrexone (Trexan, Revia) |
| Naltrexone does not produce _______. | dependence |
| This opiod addicition drug was initiallty marketed for high BP, but it is also an effective somatic treatment for some chemically dependent individuals when combined with naltrexone. It is also nonaddicting | Clonidine (Catapres) |
| A partial opiod agonist. It blocks signs and symptoms of opioid withdrawal. | Buprenorphine (Subutex) |
| Why is compliance with the nicotine patch better than compliance with nicotine gum? | Blood levels are steadier, little long-term dependence occurs, and instructions are less complicated. |
| Offering a young man treatment rather than a jail sentence is an example of using _______ ________to help the youth enter treatment to begin recovery. | therapeutic leverage |
| Why would the nurse look for an opportunity for therapeutic leverage with a patient? | The nurse's ability to develop a warm, accepting relationship with an addicted client can assist the client in feeling safe enough to start looking at problems with some degree of openness and honesty. |
| Dilation of the pupils, dryness of the oronasal cavity, and excessive motor activity, are common indicators of abuse | stimulant abuse |
| Withdrawal from ____________________ is associated with severe morbidity and mortality, unlike withdrawal from other drugs | alcohol and other CNS depressants |
| The only class of commonly abused drugs that has a specific antidote is | opiates |
| Benzodiazepines are useful for treating alcohol withdrawal because they | bind to ã-aminobutyric acid–benzodiazepine receptors |
| While helping an addicted individual plan for ongoing treatment, what intervention is the first priority for a safe recovery? | The client strives to maintain abstinence. |
| Symptoms of _____ withdrawal resemble the "flu," with runny nose, tearing, diaphoresis, muscle aches, cramps, chills, and fever. | opioid |
| Withdrawal from ______ _______ _______ _______ is complicated, requiring carefully titrated detoxification with a similar drug. Abrupt withdrawal can lead to death. | central nervous system depressants |
| Nursing assessment of an alcohol-dependent client 6 to 12 hours after the last drink would most likely reveal the presence of | tremors |
| Hyperpyrexia and convulsions are dangerous symptoms seen in _____ ____ ____ ____ overdose | central nervous system stimulant |
| ______ overdose results in lowered blood pressure with a rise in pulse rate along with respiratory depression. | opiate |
| Cocaine exerts what two main effects on the body? | both anesthetic and stimulant. |
| The most helpful message to transmit about relapse to the recovering alcoholic client is that lapses | can be learning situations to prolong sobriety |
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