Mark K Lecture #2

Denial

the #1 psychological problem in any kind of abuse

you treat it by confronting it

denial in greif/loss

normal/healthy/accepted reaction

dependency/co-dependency issue

the #2 psychological problem in abuse

dependency

when the abuser depends on the significant other to do things/make decisions for them

co-dependency

when the significant other dervives positive self-esteem from doing things for the abuser

how do you treat dependency/co-dependency?

set limits & enforce them

teach significant other to say no

dependency/co-dependency

if what the significant other is being asked to do is neutral (no harm)

manipulation

if what the significant other is being asked to do is harmful/dangerous

wernicke-korsakoff syndrome

psychosis induced by vitamin B1/thyamine deficency

lose touch with reality

amenesia with cofabulation

deal with it by redirecting the patient to something that they can do

Disulfiram (antabuse)

is a form of inversion therapy

when giving the medication, it makes you extremely sick

onset/duration = 2 weeks

pt teaching = avoid all types of alcohol

uppers

caffine, cocaine, adderall, PCP/LSD, methamphetamines

makes everything go up

downers

everything that is not an upper

makes everything go down

overdose/intoxication

too much

withdrawal

too little

to little uppers = things go down

to little downers = things go up

overdose

always assume a newborn is in what at birth?

withdrawal in the newborn

24 hours after birth

all alcoholics go through withdrawal when?

24 hours after they stop drinking

Only a minority of alcoholics get ______ within _______

delirium tremens. 72 hours

alcohol withdrawal

no harm to self/others

non-life threatening

delirium tremens

danger to self/others

can kill you

alcohol withdrawal patients get what

no restraints

regular diet

up and lib (can move around)

semiprivate room

delirium tremens patients get what

NPO/clear liquid diet

private room near nursing station

strict bedrest (no bathroom privileges)

must be in restraints (vest or 2 point)

opposite limbs

change every 2 hours

restrain new limbs first when changing

both alcohol withdrawal & delirium tremens get what

antihypertensive

tranquilizer

Vitamin B1

aminoglycosides given to treat infections that are

serious

resistant

life-threatening

gram negative

All aminoglycosides end in?

"mycin"

3 are not aminoglycosides

azithromycin

erythromycin

clarithromycin

all have "thro" in them, to throw out

toxic effects of mycin's

think of mice = ears

ototoxicity (monitor hearing, tinnitus, dizziness/vertigo)

nephrotoxicity (monitor creatine levels)

aminoglycoside facts

toxic to cranial nerve 8 (vestibulocochlear)

give every 8 hours (via IV or IM)

do not give PO aminoglycosides why?>

it is not absorbed

you can give it to hepatic emcepathy/coma patients and pre-op for bowel surgery because it sterilizes the bowel

neomycin & kanamycin

sterilizes the bowel

trough

drug is at its lowest concentration

peak

drug is at its highest concentration

TAP = trough administer peak

trough level before giving the medication

administer the medication

peak level after the medication

trough drawing times

sublingual = 30 minutes prior

IM = 30 minutes prior

IV = 30 minutes prior

Sub Q = 30 minutes prior

PO = 30 minutes prior

Peak drawing times

sublingual = 5-10 minutes after

IV = 15-30 minutes after

IM = 30-60 minutes after

Sub Q = see diabetes lecture

PO = forget about it