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Mr. D's substance-related disorders

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Question
Answer
The DSM-IV-TR identifies substance abuse as a   maladaptive pattern of substance use  
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substance abuse is manifested by   recurrent and significant adverse consequences related to repeated use of the substance  
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Which Axis are addictions considered?   Axis 1  
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In DSM V substance addiction is considered a   mental illness.  
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Abuse   To use wrongfully in a harmful way. Improper treatment or conduct that may result in injury.  
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Dependence   A compulsive or chronic requirement. The need is so strong as to generate distress (either physical or psychological) if left unfulfilled.  
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Prefrontal Cortex   Makes voluntary decisions.  
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Amygdala   Senses fear. Emotional memory of initial rush/high (sights, sounds, smell).  
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Children of alcoholics are ___ times more likely than other children to become alcoholics.   3  
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Substance abuse has been associated with   antisocial and depressive PDs  
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Alcohol acts as a   disinhibitor  
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Risk factors for substance abuse:   low self-esteem, loneliness, loses and failure (loss of job, house, spouse), low tolerance for emotional pain  
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Death rates from alcoholism among Native Americans are more than ___ the national average.   twice  
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The incidence of alcohol dependence is higher among _______ Europeans than _______ Europeans   Northern; Southern  
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EtOH   Alcohol  
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Alcohol exerts a depressant effect on the   CNS  
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The depression of the CNS, caused by alcohol, changes   behavior and mood  
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Most states consider that an individual is legally intoxicated with a blood alcohol level of   0.08%-0.10% concentration  
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How fast is alcohol metabolized by the liver?   10-15ml per hour (pure alcohol)  
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How much alcohol is in a 12oz beer?   15ml (0.5oz)  
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Alcohol is responsible for __% of all E.R. admissions.   25%  
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Alcohol is responsible for __% of all suicides.   33%  
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Alcohol is responsible for __% of all domestic violence cases.   50%  
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The two most common defense mechanisms used by individuals with alcoholism are   rationalization and denial  
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Dual Diagnosis   This is when a person has a substance disorder and a mental illness.  
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Antisocial behavior has a ____% increased risk for substance abuse.   10%-15%  
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Schizophrenia has a ___% increased risk for substance abuse.   5%-10%  
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Most dual diagnosis programs take a   more supportive and less confrontational approach.  
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Peer support groups are an ______ part of treatment.   important  
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Individuals with dual diagnosis should be encouraged to attend   12-step recovery programs such as A.A. or N.A.  
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Most abused benzodiazepine   Xanex  
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Benzodiazepine drugs   Xanex, Vlium, Ativan, Klonopin  
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Benzodiazepine intended effects:   lower anxiety, sedation  
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Benzodiazepine toxic effects:   respiratory depression, disorientation, vomiting, agitation  
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Benzodiazepine withdrawal sx:   anxiety, insomnia, possible psychotic sx, hypertension  
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Marijuana intended effects:   euphoria, sedation, pain management, hallucinations (trip)  
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Medicinal value for legalizing marijuana?   chronic pain relief  
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Marijuana toxic effects:   lung cancer, chronic bronchitis, apathy, lower sperm count  
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Marijuana withdrawal sx:   possible depression, mild  
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Is cocaine cheap or expensive?   expensive  
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Cocaine intended effects:   rush of euphoria and pleasure, increased energy  
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Cocaine toxic effects:   irritable, chest pain, tachycardia, hallucinations  
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Cocaine withdrawal sx:   can occur within 1 hour to several days after last fix, depression, insomnia, unpleasant dreams, craving  
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Nicotine intended effects:   relaxation, decreased anxiety  
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Nicotine toxic effects:   hypertension, irreversible emphysema, respiratory disease, stroke, irritation of oral mucous membranes  
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Nicotine withdrawal sx:   nervousness, restlessness, increased appetite, insomnia, craving  
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Alcohol intended effects:   relaxation, decreased social anxiety, coping with stress  
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Alcohol toxic effects:   altered judgement, decreased motor skill, decreased level of consciousness  
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Alcohol chronic use:   liver damage (fatty liver to cirrhosis), acute pancreatitis, cardiovascular damage  
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Alcohol withdrawal effects start within   4-12 hours of last drink  
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Alcohol withdrawal delirium may occur in   2-3 days after last drink  
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Alcohol withdrawal sx:   cramping, vomiting, tremors, inability to sleep, tonic-clonic seizures, increased heart rate, hallucinations  
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Antabuse   disulfiram  
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1st FDA approved med' for alcohol abuse and dependence?   Antabuse  
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Antabuse is prescribed to help people who want to quite drinking by causing a   negative reaction if the person drinks while they are taking Antabuse.  
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Alcohol is metabolized by the body into   acetaldehyde  
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acetaldehyde   a very toxic substance that causes many hangover symptoms  
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Usually the body continues to oxidize acetaldehyde into   acetic acid, which is harmless  
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Antabuse STOPS the production of   acetaldehyde  
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Antabuse PREVENTS the oxidation of   acetaldehyde into acetic acid  
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Antabuse will cause a build up of acetaldehyde that is   5-10 times greater than normal when drinking alcohol  
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Name 4 medications for alcohol withdrawal symptoms:   diazepam, lorazepam, carbamezapine, revia  
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Drug class and purpose: diazepam and lorazepam   benzodiazepines lower agitation and lowers anxiety  
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Drug class and purpose: carbamezapine   anticonvulsant and mood stabilizer  
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Drug class and purpose: revia   opioid receptor antagonist (blocks good feelings caused by alcohol)  
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1st choice for alcohol treatment   most severe alcohol addictions need IN-PATIENT facility  
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2nd choice for alcohol treatment   HOSPITAL based programs  
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3rd choice for alcohol treatment   (short or long term) RESIDENTIAL programs  
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4th choice for alcohol treatment   OUT-PATIENT  
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5th choice for alcohol treatment   12-STEP program  
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___ of recovering alcoholics will relapse   2/3  
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___ of recovering alcoholics will not respond favorably   1/3  
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Nsg Dx: Rationalization. S & Sx   "I don't have a problem with alcohol. I can quit any time I want to."  
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Nsg Dx: Rationalization. Nsg Ax   Accept client. Identify ways alcohol cause problems. Don't allow client to blame others for alcohol problems.  
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Nsg Dx: Rationalization. Outcomes   Talk about link between alcohol use and problems. Accept responsibility.  
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Nsg Dx: Ineffective Coping. S & Sx   Alcohol use to cope  
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Nsg Dx: Ineffective Coping. Nsg Ax   Set limits on manipulation. Use non-alcoholic coping. + feedback  
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Nsg Dx: Ineffective Coping. Outcomes   Use of non-alcoholic coping strategies.  
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Nsg Dx: Imbalanced Nutrition. S & Sx   dry skin, pale, underweight, malnourished  
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Nsg Dx: Imbalanced Nutrition. Nsg Ax   Consult dietician. Monitor I&O, weight, protein intake. Restrict sodium intake. Provide small, frequent, and nonirritating meals.  
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Nsg Dx: Imbalanced Nutrition. Outcomes   Vitals normal. Verbalize importance of adequate nutrition.  
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What drug is used to help recovering heroine addicts.   methadone  
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Is meth cheap or expensive to make?   Cheap  
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Meth drug action?   CNS stimulant  
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Meth destroys   tooth enamel  
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Meth can cause (mental disorder)   psychosis  
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Enabling   The tolerance, approval, giving, and or financing of drug use.  
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Enabling sabotages the   recovery of the patient.  
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Reasons ppl enable:   1 Control. 2 Rationalization. 3 Minimizing. 4 Waiting or hoping that things will get better on their own.  
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The recovery addict must first ___ that they have a drug problem.   admit/accept  
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A patient in _____(hint: a river in Egypt) can't be helped   denial  
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DSM IV says that there must be at least __ of 7 characteristics to be considered substance dependent.   3  
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7 characteristics of substance dependence:   Tolerance. Withdrawal. Larger doses and time used. Persistent uncontrollable desire. Lots of time get-n, use-n, or recov-rn from drug. Social or occupation reduced. Use continues despite knowledge of problems it causes.  
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Patient sent to hospital cause of binge drinking. Heavy drinking for years. Lab reports blood alcohol level of 250 mg/dL. Placed on chemical dependency unit for detox. The 1st signs of alcohol withdrawal should be expected at what time?   Several hours after the last drink.  
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Symptoms of Alcohol withdrawal include:   Diaphoresis, nausea and vomiting, and tremors.  
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Which medication is the physician most likely to order for a patient with alcohol withdrawal syndrome?   Chlordiazepoxide (Librium)  
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Dan has been admitted to alcohol rehab' after being fired for drinking on the job. Dan says "I don't have a problem with alcohol. I can handle booze better than any one else. My boss is a jerk." What is the best response?   "You are here because your drinking was interfering with your work, Dan."  
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Dan has been admitted to alcohol rehab' after being fired for drinking on the job. Dan says "I don't have a problem with alcohol. I can handle booze better than any one else. My boss is a jerk." The defense mechanism that Dan is using is?   Denial  
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Dan has been admitted to alcohol rehab' after being fired for drinking on the job. Dan's drinking buddies come for a visit, and when they leave, the nurse smells alcohol on Dan's breath. What is the best intervention?   Send a urine specimen from Dan to the lab for drug screening.  
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Dan, begins attendance at AA meetings. What statement reflects the purpose of this organization?   They claim they will help me stay sober.  
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Symptom of a chronic cocaine user.   Red, irritated nostrils.  
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Heroin addict withdrawal symptom.   nausea and vomiting, diarrhea, and diaphoresis.  
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A polysubstance abuser says. "The green and whites do me good after speed." What drug(s) is he abusing?   The client is abusing amphetamines and anxiolytics.  
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