ADDICTION PPT

• Anorexia Nervosa

  1. The onset is often associated with a stressful life event
  2. The client intensely fears obesity
  3. Body image is distorted, and the client has a disturbed self-concept
  4. The eating disorder can be life threatening
  5. Death can occur from starvation, suicide, or electrolyte imbalanc
• Anorexia Nervosa Assessment:

  1. Refusal to eat and appetite loss
  2. Appetite denial
  3. Feelings of lack of controld.
  4. Self-induced vomiting and self- administered enemas
  5. Exercises compulsively
  6. Overachiever and perfectionist
  7. Decreased temperature, pulse, and blood pressure
  8. Weight loss
  9. Gastrointestinal (GI) disturbance
  10. Constipation
  11. Electrolyte imbalances
  12. Scaly, dry skin
  13. Sleep disturbances
  14. Hormone deficiencies
  15. Amenorrhea for at least three consecutive menstrual periods
  16. Teeth and gum deterioration
  17. Cyanosis and numbness of extremities
  18. Esophageal varices from vomiting
  19. Bone degeneration
• Bulimia nervosa

  1. Preoccupied with body shape and weight
  2. Consumes high-calorie food in secret; guilt about secretive eating
  3. Binge-purge syndrome
  4. Lose weight though diets, vomiting, enema, cathartics, and amphetamines or diuretics
  5. experiences feelings of powerlessness or loss of control
  6. Low self-esteem
  7. Poor interpersonal relationships
  8. Mood swings
  9. Self-mutilating behavior, suicide thoughts and attempts at suicide
  10. Electrolyte imbalances
  11. Loss of tooth enamel and dental decay
  12. Stomach ulcers and rectal bleeding
  13. Esophageal varices from vomiting
  14. Cardiac disease andhypertension
• Substance abuse

  1. Client recurrently uses substances
  2. Client experiences recurrent, significant harmful consequences related to the use of substances
  3. Client has legal problems related substance abuse
• Precipitating factors of substance abuse

  1. Rebellion and peer group pressure in adolescence
  2. Pleasure-seeking experience, as the substance decreases physicaland emotional pain
  3. Group influence and peer pressure
  4. Depression
  5. Loss and grieving
• Risk factors for Alcohol Abuse

  1. Biological predisposition
  2. Depressed and highly anxious characteristics
  3. Low self-esteem
  4. Poor self-control
  5. History of rebelliousness, poor school performance,delinquency
  6. Poor parental relationships
• Psychological symptoms for Alcohol Abuse

  1. Depression
  2. Hostility
  3. Suspiciousness
  4. Rationalization
  5. Irritability
  6. Isolation
  7. Decrease in inhibitions
  8. Decrease in self-esteem
  9. Denial that a problem exists
• Complications associated with chronic alcohol use

  1. Vitamin deficiencies
  2. Alcohol-induced persistent amnesiac disorder causing severe memory problems
  3. Wernicke’s encephalopathy, causing confusion, ataxia, and abnormal eye movements
  4. Hepatitis; cirrhosis of the liver
  5. Esophagitis and gastritis
  6. Pancreatitis
  7. Anemias
  8. Immune system dysfunctions
  9. Brain damage
  10. Peripheral neuropathy
  11. Cardiac disorders
• Withdrawal and Detoxification of Alcohol:

  1. Symptoms of withdrawal usually begin 4 to 12 hours after cessation or marked reduction of alcohol intake.
  2. Can occur 6 to 8 hours after drinking has ended ordecreased, and symptoms can last 5 days or longer.
  3. Symptoms include coarse hand tremors sweating, elevated pulse and blood pressure, insomnia, anxiety, and nausea vomiting.
• Pharmacology for ALCOHOL WITHDRAWAL:

  • Safe withdrawal is usually accomplished with the administration of benzodiazepines, such as lorazepam (Ativan), chlordiazepoxide (Librium), or diazepam (Valium), to suppress the withdrawal symptoms.
• Stages of withdrawal: Stage 1

  • Anxiety
  • Anorexia
  • Insomnia
  • Tremors
  • Hyper alertness
  • Internal shaking
  • Nausea and vomiting
  • Headache
  • Increased pulse and blood pressure
  • Depression
• Stages of withdrawal: Stage 2

  • Profound confusion
  • Gross tremors
  • Nervousness
  • Disorientation
  • Illusions
  • Auditory and visual hallucinations
  • Nightmares
• Stages of withdrawal: Stage 3

  • Severe hallucinations
  • Seizures
• Stages of withdrawal: Stage 4

  • Confusion, disorientation, clouding of consciousness, and delirium
  • Hypertension diaphoresis, tachycardia
  • Visual and tactile hallucinations
  • Fluctuating levels of consciousness
  • Fever (103 to 104 F)
  • Tremors
  • Uncontrolled tachycardia
  • Severe psychomotor activity
  • Agitationk
  • Hallucinations
  • Sleeplessness
• Client education for ALCOHOL WITHDRAWAL:

  1. Educate as to the effects of the medication
  2. Instruct the client that the effects of the medication may occur for several days after discontinuance.
  3. Ensure that the client agrees to abstain from alcohol and any alcohol-containing substances.
  4. Instruct the client to avoid the use of substances that contain alcohol, such as cough medicines, rubbing compounds, vinegar, mouthwashes, and after shave lotions.
• It is useful for persons who are motivated to abstain from drinking and who are not impulsive.

  Disulfiram
• Nursing Consideration for Disulfiram (TO WATCH OUT)

  • Five to 10 minutes after a person taking disulfiram ingests alcohol, symptoms begin to appear: facial and body flushing from vasodilation, a throbbing headache, sweating, dry mouth, nausea, vomiting, dizziness, and weakness.
  • In severe cases, there may be chest pain, dyspnea, severe hypotension, confusion, and even death.
  • Symptoms progress rapidly and last from 30 minutes to 2 hours.
  • WARNING: Never give to a client in a state of alcohol intoxication or without the client’s full knowledge. Instruct the client’s relatives accordingly.
• Binge-like overeating without purging

  Compulsive overeating

• Aside from Disulfiram, this drugs sometimes prescribed for persons in recovery from alcohol abuse or dependence.It helps reduce the physical and emotional discomfort encountered during the first weeks or months of sobriety, such as sweating, anxiety, and sleep disturbances.

  Acamprosate (Campral): 

• • The client must abstain from alcohol for at least 12 hours before theinitial dose is administered.
  • The client must avoid drinking for 14 days after disulfiram therapy has been discontinued; otherwise the client is at risk for disulfiram-alcohol reaction.

  Disulfiram (Antabuse) therapy
• • Safe withdrawal is usually accomplished with the administration of benzodiazepines, such as lorazepam (Ativan), chlordiazepoxide (Librium), or diazepam (Valium), to suppress the withdrawal symptoms.


  Pharmacology for ALCOHOL WITHDRAWAL:
• Refers to the negative psychological and physical reactions that occur when use of a substance ceases or dramatically decreases.

  Withdrawal syndrome

• use of a substance that results in maladaptive behavior.

  Intoxication

• When experiencing guilt, anger, depression, boredom, loneliness, inadequacy, or ambivalence


  Responds by eating
• Food consumption is out of the individual's control and occurs in a stereotyped fashion

  Compulsive overeating