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Nursing 401 Exam #2 ~ Withdrawal, SBIRT, & Substance Use Disorders: Questions With Solutions
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Nursing 401 Exam #2 ~ Withdrawal, SBIRT, & Substance Use Disorders: Questions With Solutions
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Nursing 401 Exam #2 ~ Withdrawal, SBIRT, &Substance Use Disorders: Questions With Solutions
Attach to opioid receptors in the brain, spinal cord, and GI tract and block
transmission of pain Right Ans - How do opioids work?
Give euphoric feeling, numb emotional pain, acute relief of psych issues;
addictive, memory deficit, hallucinations/delusions, paranoia, worsening of
mental health, sedation, constipation, resp depression Right Ans - What are
the pros and cons of opioid use?
Clinical Opioid Withdrawal Scale (COWS) Right Ans - Tool used to assess
withdrawal from opioids
Can ensure safety, conduct withdrawal checks, administer pharmacological
replacement therapy, *prevent TD's if alcohol withdrawal* Right Ans - Why
is medically assisted withdrawal (MAW) better than going it alone?
Scored 0-4 or 5 for each parameter; 5-12 = Mild, 13-24 = Moderate, 25-36 =
Moderately severe, 37+ = Severe withdrawal Right Ans - How does COWS
scoring work?
Tachycardia, sweating, restlessness, dilated pupils, bone/joint aches, runny
nose, tearing, GI upset, diarrhea, tremors, yawning, goosebumps/pilorection
Right Ans - Objective symptoms of opioid withdrawal
Room with good lighting, normal = 3 Right Ans - How should pupils be
assessed during opioid withdrawal checks?
Tongue or abdomen Right Ans - Where can muscle twitching/tremors be
observed objectively?
Have patient in observable area 5 minutes before BP measurement Right
Ans - How to prevent patient running in place to raise BP during opioid
withdrawal checks
Nausea-crackers, ginger ale, tea, flat warm coke; muscle aches-hot shower,
warm compress, Tylenol; anxiety-distraction, relaxation and talk therapy
, Right Ans - What are the subjective symptoms of opioid withdrawal and some
interventions for relief?
Zofran, Phenergan PO or suppository; not IM r/t "rush" feeling Right Ans -
PRN meds given for nausea during opioid withdrawal
Vistaril or Atarax; avoid benzodiazepines Right Ans - PRN meds given for
anxiety, lacrimation, and rhinorrhea during opioid withdrawal
Trazadone Right Ans - PRN med given for insomnia during opioid
withdrawal
Tylenol (*unless esophageal varices or ulcers r/t alcohol use*),
NSAIDs/ibuprofen Right Ans - PRN meds given for myalgias during opioid
withdrawal
Kaopectate preferred, avoid Lomotil because of desired sedative effect
Right Ans - PRN meds given for diarrhea during opioid withdrawal
Narcan Right Ans - Emergency med for respiratory depression (larger
dose) and post-op recovery (smaller dose)
Methadone Right Ans - Medication given as substitution for opioids during
withdrawal, especially pregnant mothers, gives more predictable outcome in
fetus
Clonidine Right Ans - PRN med given for elevated BP during opioid
withdrawal
Suboxone (buprenorphine/Narcan) or Subutex (buprenorphine only)
Right Ans - Meds given for long-term reduction of opioid cravings; curb
cravings without producing "high" or dangerous SE's, block other opioids,
lower abuse potential
Vivitrol Right Ans - Long-term med for opioid AND alcohol dependence,
binds with opioid receptors without the high
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