NR 547 Week 8 Final Exam Review - Study Guide

Substance use disorder- Behavioral, physical, and psychological dependence are the hallmark symptoms of substance use disorders (SUDs). The direct effects of a substance on behavioral, physical, and psychological function vary based on the substance used; however, the overall impact of substance use disorders on functioning is similar regardless of the substance used Substance induced mental disorder- Substance-induced mental disorders are potentially severe central nervous system syndromes that develop because of substance abuse, medications, or toxins. Substance-induced mental disorders are diagnosed when the following criteria are met: • the symptoms represent a mental disorder presentation • there is evidence that the substance used is capable of causing the disorder and that the disorder developed within a month of using the substance • there is evidence that the disorder is not likely explained better by the diagnosis of an independent mental condition • the disorder does not occur exclusively during delirium • the disorder causes significant social, occupational, or other impairment in functioning Substance withdrawal- General features of substance withdrawal include the development of a substance-specific behavioral change, with physical and psychological symptoms, that is due to the cessation or intake reduction of a substance. Withdrawal is usually, but not always, associated with a substance use disorder. · Review scoring and use of substance abuse screening tools o SBIRT-Screening, brief intervention, and referral to treatment (SBIRT) - comprehensive and integrated public health approach to identify individuals with substance use disorders and those at risk of developing these disorders so early intervention and treatment services can be offered to prevent severe consequences. SBIRT can be executed in primary care settings, emergency departments, trauma centers, and other community settings. SBIRT is a model effective for all types of substance abuse disorders. Screening-Quickly assesses the severity of substance use and identifies the appropriate level of treatment. Brief intervention -Focuses on increasing insight and awareness regarding substance use and motivation toward behavioral change. Referral -Guidance to treatment provides those identified as needing more extensive treatment with access to specialty care. o CIWA-Ar- Clinical Institute Withdrawal Assessment-Alcohol is a highly regarded standardized instrument used to assess the severity of withdrawal symptoms (as shown below) and directs pharmacotherapy. Step 1: Administer CIWA-Ar - Administer every 4-8 hours until the score is lower than 8-10 for 24 hours. Step 2: Symptom-Triggered Regimen-If the CIWA-Ar score is 8 or higher, administer benzodiazepine: PO lorazepam (Ativan), diazepam (Valium), or chlordiazepoxide (Librium) for symptom-triggered therapy. • Increased HR • Hypertension • Mild hyperthermia • Rapid breathing Severe • Hallucinations • Seizures • Disorientation • Impaired Attention • Delirium Tremens • Death Opioids- Most people with opioid use disorder have a significant level of tolerance and will experience withdrawal with abrupt discontinuation of opioids. Opioid withdrawal symptoms include severe muscle cramps and bone aches, profuse diarrhea, abdominal cramps, rhinorrhea, lacrimation, piloerection or gooseflesh, yawning, fever, pupillary dilation, hypertension, tachycardia, and temperature dysregulation. • Barbiturates and stimulates- The withdrawal syndrome for barbiturate and barbiturate-like substances range from mild symptoms (e.g., anxiety, weakness, sweating, and