NUR2716 -Mental Health Nursing
Exam 4 Study Guide
• Health risks for heroin use:
Intoxication; apathy, lethargy, listlessness, impaired judgment, psychomotor retardation or
agitation, constricted pupils, drowsiness, slurred speech, and impaired attention and memory
Overdose: coma, respiratory depression, pupil constriction, unconsciousness, death
TNaloxone as treatment for overdose
• Effects of alcohol on the liver:
Fatty Liver – An increased buildup of fat in the liver
Hepatitis – Liver inflammation caused by drinking too much alcohol
Cirrhosis – Chronic liver damage leading to scarring and liver failure
• Interventions for alcohol withdrawal:
Withdrawal onset is about 4-12 hours after cessation of marked reduction of alcohol intake and
can take 5 days to complete. Because alcohol withdrawal can be life-threatening (transient
hallucinations, seizures or delirium or DT), detox needs to be accomplished under medical
supervision. If the patient can abstain, they withdraw from home. If not, they may require a 3-5
day admission. Safe withdraw is usually accomplished with the administration of
benzodiazepines such as lorazepam (Ativan), chlordiazepoxide (Librium) or diazepam (Valium) to
suppress the withdraw symptoms which the severity of withdraw and symptoms determine the
amount and frequency of medication. Can be accomplished with fixed-schedule dosing (aka
tapering) or symptom-triggered dosing. The protocol used is based on an assessment tool such
as the Clinical Institute Withdrawal Assessment of Alcohol Scale (box 19.2 on page 369)
• Patient education about alcohol tolerance:
As the person continues to drink, he or she often develops a tolerance for alcohol; that is, he or
she needs more alcohol to produce the same effect. After continued heavy drinking, the person
experiences a tolerance break, which means that very small amounts of alcohol intoxicate the
person.
• Patient education for chlordiazepoxide:
Used for alcohol withdrawal, 50-100 mg, repeat in 2-4 hours in necessary; not to exceed 300 mg
in a day, monitor vital signs and global assessments for effectiveness; may cause dizziness or
drowsiness, can be used on a fixed-schedule or on an as-needed basis which is just as effective
• Expected findings for cocaine intoxication:
High, euphoric feeling. Hyperactivity, hypervigilance, talkative, anxiety, grandiosity,
hallucinations, repetitive behavior, anger, fighting, impaired judgment. Tachycardia. elevated bp,
dilated pupils, perspiration, chills, nausea, chest pain, confusion, dysrhythmias, seizures, coma,
death is rare.
• Medications used to opioid
withdrawal: Methadone and heroin
• Assessing a client who has illness anxiety disorder:
Exam 4 Study Guide
• Health risks for heroin use:
Intoxication; apathy, lethargy, listlessness, impaired judgment, psychomotor retardation or
agitation, constricted pupils, drowsiness, slurred speech, and impaired attention and memory
Overdose: coma, respiratory depression, pupil constriction, unconsciousness, death
TNaloxone as treatment for overdose
• Effects of alcohol on the liver:
Fatty Liver – An increased buildup of fat in the liver
Hepatitis – Liver inflammation caused by drinking too much alcohol
Cirrhosis – Chronic liver damage leading to scarring and liver failure
• Interventions for alcohol withdrawal:
Withdrawal onset is about 4-12 hours after cessation of marked reduction of alcohol intake and
can take 5 days to complete. Because alcohol withdrawal can be life-threatening (transient
hallucinations, seizures or delirium or DT), detox needs to be accomplished under medical
supervision. If the patient can abstain, they withdraw from home. If not, they may require a 3-5
day admission. Safe withdraw is usually accomplished with the administration of
benzodiazepines such as lorazepam (Ativan), chlordiazepoxide (Librium) or diazepam (Valium) to
suppress the withdraw symptoms which the severity of withdraw and symptoms determine the
amount and frequency of medication. Can be accomplished with fixed-schedule dosing (aka
tapering) or symptom-triggered dosing. The protocol used is based on an assessment tool such
as the Clinical Institute Withdrawal Assessment of Alcohol Scale (box 19.2 on page 369)
• Patient education about alcohol tolerance:
As the person continues to drink, he or she often develops a tolerance for alcohol; that is, he or
she needs more alcohol to produce the same effect. After continued heavy drinking, the person
experiences a tolerance break, which means that very small amounts of alcohol intoxicate the
person.
• Patient education for chlordiazepoxide:
Used for alcohol withdrawal, 50-100 mg, repeat in 2-4 hours in necessary; not to exceed 300 mg
in a day, monitor vital signs and global assessments for effectiveness; may cause dizziness or
drowsiness, can be used on a fixed-schedule or on an as-needed basis which is just as effective
• Expected findings for cocaine intoxication:
High, euphoric feeling. Hyperactivity, hypervigilance, talkative, anxiety, grandiosity,
hallucinations, repetitive behavior, anger, fighting, impaired judgment. Tachycardia. elevated bp,
dilated pupils, perspiration, chills, nausea, chest pain, confusion, dysrhythmias, seizures, coma,
death is rare.
• Medications used to opioid
withdrawal: Methadone and heroin
• Assessing a client who has illness anxiety disorder:
