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NSG 552 Exam Questions and Answers 2024( A+ GRADED 100% VERIFIED).
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NSG 552 Exam Questions and Answers 2024( A+ GRADED 100% VERIFIED).
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NSG 552Naloxone (Narcan) - ANS opioid antagonist
Narcan - ANS Treatment of choice for opiate overdose
It is prescribed routinely for all patients with opiate use disorder
Very short half-life
Methadone - ANS Long acting full opioid receptor agonist at mu receptor
Restricted use to abuse trx facilities
Monitor for QTC prolongation(cardiac abnormalities
Suboxone - ANS Opioid agonist/ antagonist
Decreased cravings
Can precipitate withdrawals if used too soon after full opioid agonist-it will displace any residual
opioids from the mu receptors
Sublingual preparation that is safer
Waiver needed to prescribe outpatient
Useful for patients with opiate use disorder with comorbid pain
Suboxone can be used in pain management
Naltrexone - ANS competitive opioid antagonist
Precipitate withdrawal if used within 7 days of heroin use
Available orally or monthly depot injections
Treatment of choice for highly motivated patients
Risk for LFT elevation
Opioid(Heroin) - ANS Intoxication: miosis, hypotension, bradycardia, Low RR, unconscious
Trx: Naloxone
Withdrawal: Anxiety, lacrimation, muscle aches, abdominal cramps and diarrhea, seizures
Mgt: Buprenorphine/naloxone, clonidine, Bentyl
It is more effective at suppressing and controlling withdrawal than methadone
Cocaine - ANS Intoxication: Auditory hallucinations, agitation, violent behavior, muscle
twitching, HTN, Tachycardia
Txt: Lorazepam
Withdrawal: Antabuse use in cocaine use d/o= increases dopamine in the brain reward circuit
and act as an agonist trx in the setting of cocaine use d/o
Cocaine induced chest pain and MI - ANS Txt: Nitroglycerin, Aspirin
No Metoprolol
, Beta blockers are contraindicated in patients with cocaine induced chest pain-lowers coronary
blood flow thereby worsening ischemia
Alcohol intoxication - ANS Impaired fine motor control
Impaired judgment and coordination
Ataxic gait and poor balance
Lethargic, difficulty sitting upright, difficulty with memory
Nausea/Vomiting
Coma=Levels 300 mg/dl and over
Respiratory depression and death possible
Alcohol withdrawal - ANS Mild: Insomnia, irritability, Hand tremor
Moderate: Autonomic hyperactivity(diaphoresis, tachy, HTN), HTN
Severe: Seizures(12-48 hours consumption); hallucinations; delirium tremens(48-96 hrs after
last drink)
Anxiety
Anorexia
Nausea/Vomiting
Psychomotor agitation
Use CIWA to monitor withdrawal
CIWA protocol - ANS Area assessed: nausea/Vomiting, Tremor, paroxysmal sweats, anxiety,
agitation, tactile disturbances, auditory disturbances, visual disturbances, HA, orientation
CIWA scoring and what it means
less than 10=mild
10-15: moderate
15+=Severe
Naltrexone - ANS Opioid receptor antagonist
Can be used for both ETOH and Opioid Use d/o
Reduces desires/cravings
1st Trx: PO/IM
Will precipitate withdrawal in patients with physical opioid dependence
Acamprosate (Campral) - ANS Likely modulates glutamate transmission
First line trx in maintaining abstinence after detox
Used for relapse prevention(post detoxification)
Can be used in liver disease-not metabolized by liver
Can be administered to patients with hepatitis, liver dz and those who continue to drink alcohol
Contraindicated in severe renal disease
Decreases craving
Disulfiram (Antabuse) - ANS 2 nd Line
Blocks enzymes(Aldehyde dehydrogenase) in liver
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