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NSG 357 Psychiatric Health FINAL EXAM with Solutions
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NSG 357 Psychiatric Health FINAL EXAM with Solutions
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NSG 357 Psychiatric Health FINAL EXAMwith Solutions
what is the epidemiology of substance use disorders? -
Answer>> wer>> - 9% of the population has a substance use
disorder
- the younger the age of use of alcohol or drugs, the greater the
likelihood of misuse as adults
- adults males in their 20s are the highest rate of substance use
- comorbidity: psychiatric comorbidity = more than 50%, medical
comorbidity = hepatitis c, diabetes, CVD, HIV, pulmonary
disorders
what is the etiology of substance use disorders? - Answer>>
wer>> - neurobiological factors: addiction is chronic disease,
related to reward/pleasure center, dopamine plays large role in
this (dopamine = pleasure NT)
- psychological factors: abuse, neglect, chronic stress/trauma
- sociocultural factors: drugs and alcohol are learned as coping
mechanism
what does alcohol intoxication look like as BAC increases? -
Answer>> wer>> - 20-100 mg (0.02-0.1% BAC): mood and
behavioral changes, reduced coordination, impaired ability to
drive a car
- 101-200 mg (0.101-0.20): reduced coordination of most
activities, speech impairment, trouble walking, general impairment
of thinking and judgement
- 201-300 mg: marked impairment in thinking, memory,
cooridnation, decrease in level of alertness, memory blackouts,
nausea and vomiting
- 301-400 mg: above symptoms plus reduction of body temp and
BP, excessive sleepiness amnesia
,- 401-800 mg: difficulty walking, serious decrease in temp/BP/RR,
urinary and bowel incontinence, death
what are some medical consequences of alcohol? - Answer>>
wer>> - neuropathy/damage to your central nervous system
- malnutrution
- diabetes
- muscle cramps
- thinning bones
- fertility issues
- pancreatitis
- liver damage
- cancer
- brain shrinkage
what are some amnestic disorders that can arise from alcohol
consumption? - Answer>> wer>> - wernicke-korsakoff
syndrome = wernicke encephalopathy + korsakoff amnestic
syndrome
- treatment: B1 or thiamine, treatment should begin immediately
what are the different levels of alcohol detox/withdrawal? -
Answer>> wer>> *withdrawal typically starts 4-6 hours after last
drink
- mild to moderate withdrawal: restlessness, irritability, lack of
appetite, tremor, insomnia, impaired cognitive function, mild
perceptual changes
- severe withdrawal: severe tremors, sweating, elevation of pulse
and blood pressure, nausea, hypersensitivity to noise and light,
auditory and visual hallucinations, high fever, most extreme =
grand mal seizure
what are possible complications of alcohol withdrawal? -
Answer>> wer>> - infections
, - hypoglycemia
- GI bleeding
- undetected trauma
- hepatic failure
- cardiomyopathy
- pancreatitis
- encephalopathy
what are some medications used for alcohol withdrawal
symptoms? - Answer>> wer>> - withdrawal/detox:
benzodiazepines (chlordiazepoxide = librium, lorazepam =
ativan), barbituates (phenobarbital), other medications
(multivitamins, thiamine, magnesium)
- maintenance: disulfiram (antabuse), naltrexone
what is SBIRT when it comes to screening for alcohol abuse? -
Answer>> wer>> screening, brief intervention, referral for
treatment
what is the CAGE assessment? - Answer>> wer>> - have you
ever felt you needed to cut down on your drinking?
- have people annoyed you by criticizing your drinking
- have you ever felt guilty about drinking
- have you ever felt you needed a drink first thing in the morning
(eye-opener) to steady your nerves or to get rud of a hangover
how does cocaine affect the body? - Answer>> wer>> - CNS
stimulant: absorbed rapidly through the blood-brain barrier;
increases dopamine and norepinephrine; alters mental
awareness, energy, control
- intoxication: CNS stimulation and then depression
- withdrawal: 'brain-centered' and behavioral changes; long-term
use: depletion of norepinephrine - crash then crave
- cocaine can cause MI
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