which goal for treatment of alcohol use disorder should the nurse address first?

So nurses need to be able to recognize alcohol withdrawal syndrome and start appropriate interventions within the first 24 hours. Otherwise, such complications as seizures and substance withdrawal delirium may arise. This article discusses care for adult nongeriatric patients in alcohol withdrawal.

Full Answer

How should a nurse work with a patient beginning treatment for alcoholism?

Select the priority nursing intervention when caring for a patient after an overdose of amphetamines.a. Monitor vital signs. b. Observe for depression. c. Awaken the patient every 15 minutes. NURSINGTB.COMDownloaded by Waheed Hai ([email protected]) NURSINGTB.COMd. Use warmers to maintain body temperature.

What does a hospitalized patient diagnosed with an alcohol abuse disorder believe?

Goal 4: Develop and Improve Treatments for Alcohol Misuse, Alcohol Use Disorder, Co-Occurring Conditions, and Alcohol-Related Consequences. Considering the serious adverse consequences associated with alcohol misuse noted above, treating alcohol use disorder (AUD) and ameliorating the negative health effects associated with it are crucial.

What should be done if a patient with alcohol abuse?

The most common goal in addiction treatment is to achieve abstinence from drug and alcohol use. That’s one of the most important aims of addiction treatment, but how will you achieve it and what specific steps will you take to get there? If your treatment plan is a journey, the goal is the tall mountain in the distance that you’re headed to.

What is the nursing diagnosis for alcohol withdrawal?

21. Which goal for treatment of alcoholism should the nurse address first? a. Learn about addiction and recovery. b. Develop alternate coping strategies. c. Develop a peer support system. d. Achieve physiologic stability.

What is the most appropriate nursing goal for a patient with a substance use disorder?

What is the primary goal of the medical model of addiction?

What is the most effective intervention for substance abuse?

What are prevention suggestions for addiction?

What are the three options for drug abuse treatment?

What is typically the first step in the substance abuse treatment process?

What is a treatment plan for substance abuse?

How do you plan an intervention?

What is psychosocial treatment of substance use disorder?

What are the prevention strategies of drug and alcohol abuse?

Why is prevention so important in the field of substance use treatment?

What is the first stage in the cycle of addiction?

A patient diagnosed with alcoholism asks, “How will Alcoholics Anonymous (AA) help me?” Select the nurse’s best response. a. “The goal of AA is for members to learn controlled drinking with the support of a higher power.” b. “An individual is supported by peers while working through a 12-step plan.” c. “You must make a commitment to permanently abstain from alcohol and other drugs.” d. “You will be assigned a sponsor who will plan your treatment program.”

ANS: B Using the 12 steps, often referred to as “working the steps,” helps a person refrain from addictive behaviours while fostering individual ch...

A nurse reviews vital signs for a patient admitted with an injury sustained while intoxicated. The medical record shows these blood pressure and pulse readings at the times listed: 0200: 118/78 mm Hg and 72 beats/min 0400: 126/80 mm Hg and 76 beats/min 0600: 128/82 mm Hg and 72 beats/min 0800: 132/88 mm Hg and 80 beats/min 1000: 148/94 mm Hg and 96 beats/min What is the nurse’s priority action? a. Force fluids. b. Consult the health care provider. c. Obtain a clean-catch urine sample. d. Place the patient in a vest-type restraint.

ANS: B Elevated pulse and blood pressure may indicate impending alcohol withdrawal and the need for medical intervention. No indication is present...

A nurse cares for a patient diagnosed with an opioid overdose. Which focused assessment has the highest priority? a. Cardiovascular b. Respiratory c. Neurologic d. Hepatic

ANS: B Opioid overdose causes respiratory depression. Respiratory depression is the primary cause of death among opioid abusers. The assessment of...

A patient admitted for injuries sustained while intoxicated has been hospitalized for 48 hours. The patient is now shaky, irritable, anxious, and diaphoretic and reports nightmares. The pulse rate is 130 beats/min. The patient shouts, “Bugs are crawling on my bed. I’ve got to get out of here.” Select the most accurate assessment of this situation. a. The patient is attempting to obtain attention by manipulating staff. b. The patient may have sustained a head injury before admission. c. The patient has symptoms of alcohol-withdrawal delirium. d. The patient is having an acute psychosis.

ANS: C Symptoms of agitation, elevated pulse, and perceptual distortions indicate alcohol withdrawal delirium. The findings are inconsistent with m...

A patient admitted yesterday for injuries sustained while intoxicated believes bugs are crawling on the bed. The patient is anxious, agitated, and diaphoretic. What is the priority nursing diagnosis? a. Disturbed sensory perception b. Ineffective coping c. Ineffective denial d. Risk for injury

ANS: D The patient’s clouded sensorium, sensory perceptual distortions, and poor judgement predispose a risk for injury. Safety is the nurse’s prio...

A hospitalized patient diagnosed with an alcohol abuse disorder believes the window blinds are snakes trying to get in the room. The patient is anxious, agitated, and diaphoretic. The nurse can anticipate the health care provider will prescribe which of the following? a. A narcotic analgesic, such as hydromorphone (Dilaudid) b. A benzodiazepine, such as lorazepam (Ativan) or chlordiazepoxide (Librium) c. An antipsychotic, such as olanzapine (Zyprexa) or thioridazine (Mellaril) d. A monoamine oxidase inhibitor antidepressant, such as phenelzine (Nardil)

ANS: B Sedation allows for safe withdrawal from alcohol. Benzodiazepines are the drugs of choice in most regions because of their high therapeutic...

A hospitalized patient diagnosed with an alcohol abuse disorder believes spiders are spinning entrapping webs in the room. The patient is fearful, agitated, and diaphoretic. Which nursing intervention is indicated? a. Check the patient every 15 minutes b. One-on-one supervision c. Keep the room dimly lit d. Force fluids

ANS: B Immediate medical attention, ongoing assessment and supervised treatment is necessary to promote physical safety until sedation reduces the...

A patient diagnosed with an alcohol abuse disorder says, “Drinking helps me cope with being a single parent.” Which therapeutic response by the nurse would help the patient conceptualize the drinking objectively? a. “Sooner or later, alcohol will kill you. Then what will happen to your children?” b. “I hear a lot of defensiveness in your voice. Do you really believe this?” c. “If you were coping so well, why were you hospitalized again?” d. “Tell me what happened the last time you drank.”

ANS: D The correct response will help the patient see alcohol as a cause of the problems, not a solution, and begin to take responsibility. This ap...

A patient asks for information about Alcoholics Anonymous. Select the nurse’s best response. a. “Alcoholics Anonymous is a form of group therapy led by a psychiatrist.” b. “Alcoholics Anonymous is a self-help group for which the goal is sobriety.” c. “Alcoholics Anonymous is a group that learns about drinking from a group leader.” d. “Alcoholics Anonymous is a network that advocates strong punishment for drunk drivers.”

ANS: B Alcoholics Anonymous (AA) is a peer support group for recovering alcoholics. Neither professional nor peer leaders are appointed.

How to treat alcohol use disorder?

A variety of effective interventions are available to treat AUD. These include professionally led behavioral treatments to help people identify and change behaviors that contribute to alcohol misuse, three U.S. Food and Drug Administration (FDA)–approved medications, and mutual support groups, such as Alcoholics Anonymous and other peer-led groups. Research shows that behavioral and pharmacological therapies are most effective when used in combination, and that most people with AUD who get some form of treatment benefit from it.

Why are people deterred from alcohol?

They may be deterred by the stigma associated with alcohol misuse and alcohol-related disease, financial constraints, or logistical challenges that prevent them from attending treatment , such as lack of transportation or childcare.

What are the medications used for AUD?

There are currently three medications approved by the FDA for treating AUD: disulfiram, naltrexone, and acamprosate.

How to reduce alcohol consumption?

Cognitive behavioral therapy, motivational therapy, community reinforcement, family and couples therapy, and brief interventions have consistently been found to reduce rates of heavy drinking. Such behavioral treatments for AUD share features, such as having health care professionals work with people to set attainable alcohol reduction goals, build a strong social support system, and develop skills to cope with or avoid triggers that might contribute to relapse. Behavioral treatments also differ in certain ways. For example, cognitive behavioral therapy is aimed at changing the thought processes that contribute to drinking and teaching coping skills directed at managing risky situations. Motivational enhancement therapy, on the other hand, seeks to facilitate and strengthen internal motivation to change drinking behavior by aligning changes in behavior with life goals.

How does recovery from AUD work?

Though definitions vary, one conceptualization of recovery from AUD is the disappearance of AUD symptoms accompanied by a state of well-being that builds resilience to relapse . Recovery is possible and is associated with parallel neuropsychological and neurobiological changes. However, the process is not the same for everyone. Some people need longer or more intense treatments, whereas others recover more quickly and with minimal intervention. Relapse is often a part of the process; it may take several attempts before someone can stop or reduce drinking over the longer term. A return to drinking after a period of abstinence is especially likely during times of stress or when individuals are exposed to people or places they associate with drinking. Currently, little is known about the factors that facilitate or inhibit long-term recovery, including why some people can recover without some form of assistance. Developing a better understanding of the recovery process, including the factors that enable people to maintain changes in their drinking behavior and promote resilience to relapse, will inform the development of additional effective treatment interventions.

What is the purpose of research in behavioral therapy?

Promote research to enhance the effectiveness of current, evidence-based behavioral therapies for a wider range of patients across a wider range of treatment settings.

How can mobile technology help with drinking?

Smart phones, text messaging, social media applications, biological sensors, and other devices are being used to engage patients outside of usual care settings, assist them in monitoring their alcohol consumption, and provide personalized resources and support where and when they need it most, such as at times or places they tend to use alcohol. (See “NIAAA Wearable Alcohol Biosensor Challenge.”) Although there are significant challenges to optimizing and facilitating uptake of electronic health technologies, research in this area has the potential to increase the number of people with access to effective, personalized treatment interventions and continuing care.

What is the goal of addiction treatment?

It’s easier to understand what a goal is with an example. The most common goal in addiction treatment is to achieve abstinence from drug and alcohol use. That’s one of the most important aims of addiction treatment, but how will you achieve it and what specific steps will you take to get there? If your treatment plan is a journey, the goal is the tall mountain in the distance that you’re headed to. You can see it, but you can’t see all the roads that will take you there. Still, defining a goal is essential in pointing you in the right direction, informing the rest of your treatment plan.

What are the different types of treatment for alcohol abuse?

There are a few types of treatment for alcohol abuse. Behavioral therapies are standard for all addiction treatments, but they can also be applied to alcohol use disorders. The behavioral treatments are geared toward changing behavior through counseling and are led by a mental health professional, and supported by studies indicating their positive outcomes.

What is addiction recovery?

Addiction recovery programs aim to help you craft goals that are relevant and meaningful to you. To do this, you’ll be encouraged to consider your personal expectations against the expectations of those around you and create a plan on how you can achieve a healthier way of life.

What is intervention in addiction?

Interventions may be a key component in helping a client advance in their treatment plan. They provide accountability, challenges, and direction during treatment. Addiction recovery programs aim to help you craft goals that are relevant and meaningful to you.

What are the components of a treatment plan?

Your treatment plan will include three major components: goals, objectives, and interventions.

Why is it important to have a treatment plan for substance abuse?

The ultimate goal of an addiction recovery program is to support you as you embark on a healthier way of life. No-one controls the indefinite future. You can only control your personal actions in any given moment.

How many people die from alcoholism each year?

The effects of alcohol are widely known, and the National Institute on Alcohol Abuse and Alcoholism estimates that each year, 88,000 people in the die from alcohol-related causes.

What is the name of the drug that is prescribed for alcohol abuse?

The patient is anxious, agitated, and diaphoretic. The nurse can anticipate the health care provider will prescribe a (n): a. narcotic analgesic, such as hydromorphone (Dilaudid).

What is the goal of AA?

a. "The goal of AA is for members to learn controlled drinking with the support of a higher power."

How often should you check a patient?

a. Check the patient every 15 minutes

What is the priority of a nurse?

The patient's clouded sensorium, sensory perceptual distortions, and poor judgment predispose a risk for injury. Safety is the nurse's priority. The other diagnoses may apply but are not the priorities of care.

What are the symptoms of alcohol withdrawal?

Symptoms of agitation, elevated pulse, and perceptual distortions indicate alcohol withdrawal delirium. The findings are inconsistent with manipulative attempts, head injury, or functional psychosis.

What is the primary cause of death among opioid abusers?

Opioid overdose causes respiratory depression. Respiratory depression is the primary cause of death among opioid abusers. The assessment of the other body systems is relevant but not the priority. See relationship to audience response question.

Can cough syrup cause alcohol disulfiram?

Many liquid medications, such as cough syrups, contain small amounts of alcohol that could trigger an alcohol-disulfiram reaction. Using alcohol-based skin products such as aftershave or cologne, smelling alcohol-laden fumes, and eating foods prepared with wine, brandy, or beer may also trigger reactions.

What chapter is the substance use disorder deck?

Flashcards in Chapter 19: Substance Use Disorders Deck (35)

What is the goal of AA?

a. “The goal of AA is for members to learn controlled drinking with the support of a higher power.”

What are the vital signs of a patient in the emergency department?

In the emergency department, a patient’s vital signs are BP 66/40 mm Hg; pulse 140 beats/min; respirations 8 breaths/min and shallow. The nursing diagnosis is Ineffective breathing pattern related to depression of respiratory centre secondary to narcotic intoxication. Select the priority outcome.#N#a. The patient will demonstrate effective coping skills and identify community resources for treatment of substance abuse within 1 week of hospitalization.#N#b. Within 4 hours, vital signs will stabilize, with BP above 90/60 mm Hg, pulse less than 100 beats/min, and respirations at or above 12 breaths/min.#N#c. The patient will correctly describe a plan for home care and achieving a drug-free state before release from the emergency department.#N#d. Within 6 hours, the patient’s breath sounds will be clear bilaterally and throughout lung fields.

What is an alcoholics Anonymous?

a. “Alcoholics Anonymous is a form of group therapy led by a psychiatrist.”

What is the priority of a nurse?

The patient’s clouded sensorium, sensory perceptual distortions, and poor judgement predispose a risk for injury. Safety is the nurse’s priority. The other diagnoses may apply but are not the priorities of care.

What are the symptoms of alcohol withdrawal?

Symptoms of agitation, elevated pulse, and perceptual distortions indicate alcohol withdrawal delirium. The findings are inconsistent with manipulative attempts, head injury, or functional psychosis.

How to care for a patient after an overdose?

Select the priority nursing intervention when caring for a patient after an overdose of amphetamines.#N#a. Monitor vital signs.#N#b. Observe for depression.#N#c. Awaken the patient every 15 minutes.#N#d. Use warmers to maintain body temperature.

What is the importance of safety in nursing?

2. Safety is always the priority when caring for patients. Ensuring safety includes completing a suicide risk assessment.

What is a nurse caring for?

The nurse is caring for a patient with an addictive disorder who is currently drug-free. The pt is experiencing repeated occurrences of viid, frightening images and thought. Which term would the nurse use to document this finding?

Why are benzodiazepines used in hospitals?

Benzodiazepines are the drugs of choice in most regions because of their high therapeutic safety index and anticonvulsant properties. A hospitalized patient diagnosed with an alcohol abuse disorder believes spiders are spinning entrapping webs in the room. The patient is fearful, agitated, and diaphoretic.

How long does it take for alcohol withdrawal to peak?

Patients who are exhibiting hyperalertness and jerky movements and who startle easily are most likely in a state of alcohol withdrawal, a condition that peaks in 24 to 48 hours after cessation or reduction of alcohol intake and then rapidly and dramatically disappears unless the withdrawal process progresses to alcohol withdrawal delirium.

What are the symptoms of alcohol delirium?

4. Paranoid delusions, fever, and fluctuating levels of consciousness are associated with alcohol delirium and are considered a medical emergency and can result in death if not treated.

What is tolerance in medicine?

ANS: 2. 1. Tolerance occurs when a patient's physiological reaction to a drug decreases with repeated administration of the same dose. 2. Flashbacks occur in a drug-free state and involve visual distortions, time expansion, loss of ego boundaries, and intense emotions.

Why do we use the 12 steps?

Using the 12 steps, often referred to as "working the steps," helps a person refrain from addictive behaviours while fostering individual change and growth . Peer support, accomplished by obtaining a sponsor prior to discharge, can increase the patient's likelihood of attendance at 12-step meetings. The other options are incorrect.

How to help someone with alcoholism?

It is important that as you try to help your loved one, you find a way to take care of yourself as well. It may help to seek support from others, including friends, family, community, and support groups. If you are developing your own symptoms of depression or anxiety, think about seeking professional help for yourself. Remember that your loved one is ultimately responsible for managing his or her illness.

What is behavioral therapy?

Also known as alcohol counseling, behavioral treatments involve working with a health professional to identify and help change the behaviors that lead to heavy drinking. Behavioral treatments share certain features, which can include:

What is AA peer support?

Alcoholics Anonymous (AA) and other 12-step programs provide peer support for people quitting or cutting back on their drinking. Combined with treatment led by health professionals, mutual-support groups can offer a valuable added layer of support.

Why is matching the right therapy to the individual important?

Matching the right therapy to the individual is important to its success . No single treatment will benefit everyone. It may also be helpful to determine whether treatment will be adapted to meet changing needs as they arise.

What is the NIAAA working on?

By studying the underlying causes of alcoholism in the brain and body, NIAAA is working to identify key cellular or molecular structures — called “targets” — that could lead to the development of new medications.

Does drinking cause anxiety?

Depression and anxiety often go hand in hand with heavy drinking. Studies show that people who are alcohol dependent are two to three times as likely to suffer from major depression or anxiety over their lifetime. When addressing drinking problems, it’s important to also seek treatment for any accompanying medical and mental health issues.

What is the nursing care plan for alcohol withdrawal?

Nursing care planning for patients who are undergoing alcohol withdrawal includes: maintaining physiological stability during the acute withdrawal phase, promoting safety, providing appropriate referral and followup, and involvement of SO in the process.

Why is alcohol used in social settings?

ADVERTISEMENTS. Alcohol, a central nervous system depressant, is used socially in our society for many reasons: to enhance the flavor of food, to encourage relaxation and conviviality, for celebrations, and as a sacred ritual in some religious ceremonies. Therapeutically, it is the major ingredient in many OTC/prescription medications.

Why do people take BZDs?

BZDs are commonly used to control neuronal hyperactivity because of their minimal respiratory and cardiac depression and anticonvulsant properties. Studies have also shown that these drugs can prevent progression to more severe states of withdrawal. IV and PO administration is preferred route because IM absorption is unpredictable. Muscle-relaxant qualities are particularly helpful to patient in controlling “the shakes,” trembling, and ataxic quality of movements. Patient may initially require large doses to achieve desired effect, and then drugs may be tapered and discontinued, usually within 96 hr. Note: These agents are used cautiously in patients with known hepatic disease because they are metabolized by the liver, although Serax has a shorter half-life.

What is the effect of a hyperactive patient?

Reduces external stimuli during hyperactive stage. Patient may become more delirious when surroundings cannot be seen, but some respond better to quiet, darkened room.

What are the drugs that suppress alcohol withdrawal?

Barbiturates: phenobarbital, or possibly secobarbital (Seconal), pentobarbital (Nembutal) These drugs suppress alcohol withdrawal but need to be used with caution because they are respiratory depressants and REM sleep cycle inhibitors. Arrange “Intervention” (confrontation) in controlled setting.

Why do you give antianxiety pills during withdrawal?

Antianxiety agents are given during acute withdrawal to help patient relax, be less hyperactive, and feel more in control.

How to develop a trusting relationship with alcohol?

Develop a trusting relationship through frequent contact being honest and nonjudgmental. Project an accepting attitude about alcoholism.

What is a nurse's role in a substance use disorder?

A nurse is providing health education for the family of a patient who has a substance use disorder. How should the nurse best explain the etiology of this disorder?

What is a patient who has a long history of heavy alcohol use and has been admitted to the hospital for

A patient has a long history of heavy alcohol use and has been admitted to the hospital for traumatic injuries after a motor vehicle accident. How should the nurse best assess the patient for physical dependence on alcohol?

What is the medication for alcoholism?

A patient who suffers from alcoholism is prescribed disulfiram (Antabuse). How does this medication assist the patient in refraining from ingestion of alcohol?

Is substance abuse a cultural concept?

D. "Substance abuse is considered to be primarily a cultural concept, since definitions vary widely across time and place."

Does antabuse require more frequent administration?

D. The patient will require more frequent administration of disulfiram (Antabuse).

What does it mean when a nurse does not notify the provider of a change in condition for a client who

A. A nurse does not notify the provider of a change in condition for a client who has schizophrenia. (Negligence is the failure to act in a manner which follows the standard of care. The nurse should inform the provider of any changes in a client's condition. Failure to do so is considered negligence.)

Why should a nurse request transport for the client to the nearest emergency department?

(The nurse should request transport for the client to the nearest emergency department because the client has manifestations of serotonin syndrome. Serotonin syndrome is a life-threatening syndrome and is caused by an over activation of the central serotonin receptors. This is related to interactions with taking an SSRI and trazodone along with St. John's wort. Manifestations of serotonin syndrome include hypertension, tachycardia, vomiting, abdominal pain, and mental status changes.)

What should a nurse do first?

However, there is another action that the nurse should take first.) A. Remove harmful objects from the client's room. (The greatest risk to this client is self-injury or injury to others. Therefore, the first action the nurse should take is to remove harmful objects from the client's room to protect the client.)

What is confidentiality in nursing?

D. Confidentiality (Confidentiality means respecting the client's privacy regarding personal issues. The nurse should uphold this ethical principle when making decisions about sharing client information with others.)

What does "justice" mean in nursing?

B. Justice (Justice means distributing care or resources equally among clients or groups of clients. The nurse is currently caring for an individual client who requires information about a prescribed medication.)

What is autonomy in nursing?

A. Autonomy (Autonomy involves respecting the client's right to make their own decision. The nurse is currently providing information. The client has not made a decision yet about taking the medication.)

What type of doctor can provide individual or family therapy?

C. Psychologist (Although psychologists can provide individual or family therapy for clients, they do not usually address issues regarding financial support and community resources.)