Professional Documents
Culture Documents
Substance Abuse
Substance Abuse
Substance Abuse
M. Zubair
Assistant Professor Kmu
DEFINTIONS
• ALCOHOL
• NARCOTICS (Opioids, synthetics)
• SEDATIVES- HYPNOTICS
• STIMULANTS- Caffeine, Nicotine
Cocaine, Amphetamine
CLASSES OF PSYCHOACTIVE
SUBSTANCES
• HALLUCINOGENS
• CANNABIS
• INHALANTS
• RAVE AND TECHNO DRUGS “Designer
drugs”
ALCOHOL STATISTICS 2001
WITHDRAWAL
• EARLY 6-8 HOURS AFTER LAST DRINK
• DT’S IN 72 HOURS
• ANXIETY, ANOREXIA, INSOMNIA, N&V TREMOR,
“SHAKY”, DELIRIUM, ALTERED L.O.C., PULSE &
B.P., DIAPHORESIS
• POSSIBLE SEIZURES
• VISUAL, TACTILE HALLUCINATIONS
Nursing Diagnosis
Substance Abuse
Risk for injury…. (withdrawal)
Risk for violence to self… (withdrawal)
• Ineffective denial related to weak ego…
• Ineffective coping related to inadequate coping skills…
• Low self-esteem related to a weak ego…
• Risk for infection related to altered immunity and poor
nutrition…
• Imbalanced nutrition less than body requirements/
fluid volume deficit related to not eating or drinking….
TREATMENT OF ALCOHOL WITHDRAWAL
• FLUID-ELECTROLYTE REPLACEMENT
• MONITOR VITAL SIGNS
• SAFETY-ONE-TO ONE
• PRESENT REALITY, DECREASE ANXIETY
• SEIZURE PRECAUTIONS
• SUPPORTIVE LIMIT-SETTING
• REINFORCE DISEASE CONCEPT
• CONSISTENCY
• REFER TO ALCOHOLICS’ ANONYMOUS &
EDUCATION PROGRAM AFTER DETOX.
SEDATIVE, HYPNOTIC OR ANXIOLYTIC
INTOXICATION
• LABILITY
• DECREASED CONTROL OF IMPULSES/INHIBITIONS
• IRRITABLE
• SLURRED SPEECH
• INCOORDINATION/UNSTEADY GAIT
• IMPAIRED ATTENTION AND JUDGEMENT
• CAN LEAD TO COMA AND DEATH
SEDATIVE, HYPNOTIC OR ANXIOLYTIC (
CONT..)
WITHDRAWAL
• POTENTIAL FOR SEIZURES
SAME AS FOR
AMPHETAMINES
OPIODS / NARCOTICS
INTOXICATION
• DECREASED B.P. AND RESPIRATIONS
• CONSTRICTED PUPILS
• DROWSINESS
• SLURRED SPEECH
• PSYCHOMOTOR RETARDATION
• EUPHORIA/DYSPHORIA
• IMPAIRED MEMORY/JUDGEMENT
OPIODS / NARCOTICS ( CONT..)
OVERDOSE
• PUPILS CONSTRICTED, BUT CAN BE DILATED
• RESPIRATORY DEPRESSION/ARREST
• COMA
• SHOCK
• CONVULSIONS AND DEATH
OPIODS / NARCOTICS ( CONT..)
WITHDRAWAL
• YAWNING
• ANOREXIA
• INSOMNIA
• RUNNY NOSE
• CRAMPS
• CHILLS
• NAUSEA
• PILORECTION OF SKIN
NURSING CARE FOR O/D AND W/D
NARCOTICS
OVERDOSE
• NARCAN
WITHDRAWAL
• SUPPORTIVE MEASURES, IF NOT LIFE
THREATENING (COLD TURKEY)
• (METHADONE MAY BE USED IN SEVERAL
SITUATIONS)
HALLUCINOGENS- LSD / PCP
INTOXICATION/OD
• INTENSIFIED PRECEPTIONS
• PCP, LSD- DILATED PUPILS AND TACHYCARDIA, TPR.
AND BP
• ANXIETY/DEPRESSION
• ILLUSIONS AND HALLUCINATIONS
• DEPERSONALIZATION
• PANIC REACTION GRANDIOSITY, PARANOIA
PCP : ASSAULTIVENESS; JERKING; SEIZURES
LSD: “TRIPS” AND “FLASHBACKS”
HALLUCINOGENS- LSD / PCP
NURSING CARE
No crisis
Crisis
Assessment of Balancing Factors
• Perception of Event
– Cognitive skills
– Maintains self image and sense of purpose
– Redefines the event
• Situational Supports
– How well does patient utilize other people for support?
Assessment of Balancing Factors
Coping Skills
Ability to express strong emotions
Preferred modes: does client prefer or have
skill with actions, like exercise, writing, crying,
talking?
Ability to tolerate uncertainty
Problem solving ability; making plans
CRITICAL THINKING
Perception of event
Situational Supports
Coping strategies
Crisis Intervention
• Definition:
– Is a form of brief focused and time limited therapy
which deals with the person’s present problem
and its immediate resolution ovly.
Crisis intervention consist of three phases:
– Crisis counseling
– Crisis care
– Crisis intervention in case of attempted suicide
Crisis counseling
• Listen actively and with concern
• Encourage open expression with concern
• Help the patient gradually accept reality.
• Link the patient to social work
• Engage in decision, counseling, and problem
solving with the patient
• Reinforce newly learned coping device
• Follow up the care after resolution of crisis
Crisis care
• Provide situational support
• Remove stress
• the nurses and the client work together to solve
the problem
• Help the client focus on the problem and specific
goal leading to its resolution
• Help the client to develop healthier coping skills
• helpful strategies may include open expression of
feeling, progressive relaxation and physical exercise
Crisis intervention in case of attempted suicide