*Alcohol/Opiates Withdrawals signs and symptoms plus more

Blue lips, clammy skin, pinpoint pupils, slow heartbeat, unresponsive to voice or touch.

What are the primary symptoms of opioid overdose?

What should you do when you recognize symptoms of an opioid overdose?

Call 911.

What is Naloxone also known as?

Narcan.

How long does Naloxone typically last?

10-15 minutes.

Addiction, cellulitis, pneumonia, infection, overdose, malnutrition, decreased testosterone.

long-term effects of opiate use

What can untreated opioid use disorder cause during pregnancy?

Fetal growth restriction, placental abruption, preterm labor, fetal convulsions.

What is one effect of heroin on a newborn?

Neonatal abstinence syndrome.

What scale is used to assess opioid withdrawal?

COWS Scale.

What symptoms peak during opioid withdrawal?

Nausea, vomiting, stomach cramps, diarrhea, goosebumps.

What is the mild range of the COWS Scale?

5-12.

What is a pharmacological management option for acute opiate withdrawal?

Clonidine.

What is one outpatient treatment modality for opiate use disorder?

Cognitive Behavioral Therapy (CBT).

What medication is used for craving reduction in opiate use disorder?

Naltrexone.

How is alcohol absorbed in the body?

20% through the small intestine and 80% through the stomach

What are some short-term effects of alcohol intoxication?

Slurred speech, poor attention, disinhibition, fuzzy thinking.

Cirrhosis of the liver (damage of liver tissues that turns into scar tissues)

-Esophageal varices (Enlarged veins in esophagus)

-Wernicke’s encephalopathy (Acute mental change, confusion, ataxia which is poor muscle control that causes clumsy movements,  decreased incoordination, and vision is decreased

-Korsakoff’s psychosis

Portal hypertension

-Gastric Ulcers

-Pancreatitis, development of diabetes

-Myopathy (disease of muscles that controls voluntary movements)

-Impotence (Inability to get erection)

-Decreased testosterone

-Depletion of B Vitamins - specifically thiamine

-Enlargement of cerebral ventricles, r/t atrophy of the cerebrum

What are chronic effects of alcohol use?

What is the onset time for alcohol withdrawal symptoms?

6-24 hours after the last drink.

What do mild alcohol withdrawal symptoms include?

Anxiety, insomnia, mild hypertension, headache.

What is delirium tremens and when do they start from last drink?

Severe alcohol withdrawal syndrome with hallucinations and disorientation. Starts 2-3 days from last drink and can last up to 14 days.

What is the CIWA scale used for?

To categorize the severity of alcohol withdrawal.

What non-pharmacological management is suggested for alcohol withdrawal?

Promotes client safety 

-can use CIWA or scheduled assessments to objectively measure severity of withdrawal and help determine treatment

-Monitor VS and behavior closely according to unit protocol or provider orders

-Assess mental status and orient as needed

-promote sleep and rest

-offer fluids and light foods during periods of lucidity

-maintain quiet, non-stimulating environment

-Institue seizure precautions

-educate family/friends/visitors regarding contraband

What medications are typically used for acute alcohol withdrawal?

Benzodiazepines, Thiamine, Folate, Multivitamins.

What vital signs should be monitored before giving medications for alcohol withdrawal?

Vital signs, monitor intake and minimum of every 4 hours can range from 15 minutes to 24 hours when the client is stable

Labs:

-Blood alcohol level 

-Aspartate amino transferase (AST)

-Alanine amino transferase (ALT)

*(AST) and (ALT)  both are labs that look at levels of enzymes, high enzyme levels indicate liver damage

What is a risk associated with long-term benzodiazepine use?

-avoid using with other drugs that decrease CNS like Methadone and Buprenorphine

-avoid with alcohol

-avoid with Barbiturates

-avoid with opioids 

-Dependance can occur or cross tolerance can develop with long term use

What are medication-assisted treatment for alcohol use disorder?

Disulfiram, Acamprosate, Naltrexone

Why is a pregnancy test important before medication-assisted treatment in women?

To assess possible risks to a fetus.

What can happen if benzodiazepines are mixed with CNS depressants?

Increased risk of CNS depression and overdose.

What are the common nursing diagnoses related to alcohol withdrawal?

Risk for injury, risk for seizures, risk for cognitive impairment.

What are some signs of acute opiate withdrawal?

-Yawning

-Tearing (lacrimation)

-Runny nose (rhinorrhea)

-sweating

-drug craving

What factor can lead to acute opiate withdrawal in newborns?

Maternal opiate use during pregnancy.

What are potential infections that can arise from long-term opiate use?

HIV, hepatitis, or other blood borne illnesses.

Long term effects of Opioid Use -Addiction

-Cellulitis/Sepsis

-Abscesses (build up of pus in any part of the body)

-Pneumonia

-Endocarditis

-Infection: Possible HIV, hepatitis infection, or other blood borne illnesses, STI

*-Overdose (accidental or intentional)

-Malnutrition

-Sexual dysfunction

-Decreased testosterone

-impaired immune response

-opioid induced hyperalgesia (increase sensitivity in pain. Response)