Addiction DB
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Jaquelin Vazquez Addiction Case Studies Discussion Alcohol Complications and Addiction (Jim Green):
8. What would be helpful to know regarding Mr. Green’s substance abuse history? What other questions might you ask (and why)? (Jaquelin)
It would be important for the physician to know how much J.G. has drank, how he has been drinking, any effects he has related to his drinking, and types of withdrawal symptoms he has experienced. It would also be important to know any other substances he has used in the past. Any history of complications such as seizures, while withdrawing from substances should be determined. Any current medical problems, current or past mental health treatment and any substance abuse treatment (depression or anxiety). 9. What medications (include the drug class) are commonly prescribed for patients withdrawing from alcohol? Explain the rationale for each of the drugs used during acute alcohol withdrawal. (Include at least three medications from different drug classes) (Jaquelin)
Medications that are commonly prescribed for patients withdrawing from alcohol would be benzodiazepines, adrenergics, and anticonvulsants. An example of benzodiazepine would Ativan (lorazepam); which is used in alcoholics to treat delirium tremens. Precedex is an adrenergic used to sedate the patient in severe alcohol withdrawal. Topamax is an anticonvulsant used to prevent seizures from alcohol withdrawal. 10. What chronic health problems are associated with alcoholism? (Jaquelin) Some chronic health problems associated with alcoholism are liver disease, hepatitis, cirrhosis, liver cancer, cardiac problems, chronic heart disease, hypertension, pancreatitis, gastritis, esophageal varices, stroke, dementia, and memory loss. Opioid Addiction (Jenna): 3. Knowing Jenna’s recent history what other assessments/screening should be implemented?
Jenna should be screened for any STD and pregnancy test. Careful assessment of physical and psychological indices of pain, and evaluation for other conditions that may be contributing to pain (i.e., recurrent infection, thrombosis, etc.) are indicated. Symptoms of opioid withdrawal should also be assessed. IN this
setting, it is essential to discuss the pain management plan with the patient in a non-judgmental manner that describes the course of treatment. Anxiety concerning withdrawal or unmanaged pain can drive requests for additional opioid medications or unusual behaviors during treatment. Monitoring in patients receiving high-dose opioids must include vital signs and overall level of arousal and wakefulness, as well as other clinical assessments like oxygen saturation and end-tidal carbon dioxide measurement (capnography). These tools may indicate either insufficient or excessive opioid dose. 4. Jenna tells you she has never taken Subutex or Suboxone and asks for some
information on the medication she says, “Isn’t that the stud that makes you go
into withdrawal right away?” How should the nurse respond? Subutex is only buprenorphine, meanwhile Suboxone is composed of buprenorphine and naloxone. Buprenorphine and the combination of buprenorphine and naloxone are used to treat opioid dependence (addiction to opioid drugs, including heroin and narcotic painkillers). References Halter, M. J. (2022). Varcarolis’ foundations of Psychiatric-Mental Health Nursing: A clinical
approach
. Elsevier.
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