Addiction CB Prework - xxxxxx PDF

Preview

Summary

xxxxxx...

Description

Concept: Addiction Concept Based Case Based Experience Prep Work This document will be worth 10 points of your grade for the day. Please submit to Canvas prior to the start of your scheduled CB experience. Must be your own work in your own words. No copy and paste. Plagiarism will result in a zero for the day. This document may also serve as a study guide for you as you continue your program here at Nightingale, and as you study for the HESI exams and the NCLEX. Scenario 1: Robert Jackson, Alcohol Withdrawal Purpose Overview

Required Reading: Skill Review: Please review the following skills. Pharmacology Review: Please review the following medications. Questions 1: How can alcohol withdrawal be predicted and managed? 1 point Question 2: How can a restless, combative patient be managed? 1 point Question 3: What is the therapeutic effect of lorazepam? 1 point

To provide students with the opportunity to assess, intervene, and manage care for an anxious, agitated patient experiencing alcohol withdrawal. Robert Jackson is a 57-year-old white male with a history of pancreatitis, alcohol abuse, and alcoholic cirrhosis of the liver. On Tuesday at 0900, he was admitted to the medical surgical unit with abdominal pain related to pancreatitis. He has been started on the CIWA-Ar alcohol withdrawal protocol and has been receiving IV morphine to control pain. The scenario takes place on Tuesday at 1900, at which time the patient is experiencing anxiety, agitation, tremors, and sweats related to alcohol withdrawal. Concept 37 in Concepts for Nursing Practice, 2e by Giddens. Therapeutic Communication Medication Administration: Piggyback Infusion Intravenous Therapies: Site Assessment Ondansetron Morphine Mylanta Lorazepam They can be predicted from the history of the patient. Minor signs are a prediction of what is to come if not managed right away. Such as tremors, diaphoresis, nausea/vomiting, hypertension, tachycardia, hyperthermia, tachypnea To manage a restless combative person, the use of interventions such as benzos, psychotics, sedatives to relax the patient. When it is bad enough, restraints can be applied. This drug is mainly used for anxiety, as it works by enhancing GABA in the CNS

P Ackerman, DNP, CNE, RN 2019 Simulation Learning System by Elsevier Scenario Psy 2 & 5

Scenario 2: Tyler Morgan, Substance Abuse Purpose Overview

Required Reading: Skill Review: Please review the following skills. Pharmacology Review: Please review the following medications.

To provide students with the opportunity to assess a patient’s drug use history and to provide relevant patient education. Tyler Morgan is an 18-year-old white male admitted to the psychiatric unit on Thursday at 1100 with a diagnosis of depression and substance abuse (cocaine). Tyler is a high school senior who has been skipping school, not eating, sleeping excessively, and abusing cocaine. The scenario takes place on Thursday at 1600, at which time the student is asked to obtain answers to the admission history questions regarding drug use that the patient refused to answer upon admission. Concept 37 in Concepts for Nursing Practice, 2e by Giddens. Therapeutic Communication

Acetaminophen Venlafaxine Trazodone Acetaminophen/oxycodone 5/325 mg Questions 1: What signs Agitation, restlessness, irritability, depression, anhedonia, fatigue, poor and symptoms indicate concertation, inactivity cocaine withdrawal? 1 point Question 2: How does Depressed people typically have lower dopamine levels, cocaine on the cocaine abuse worsen other hand increases your dopamine levels, after a come down from the depression? drug, the dopamine levels flatten out, which in the case of depression 1 point makes it worse as there is low levels already. Question 3: What can a Request to come back at a better time. Explain to the patient that the nurse do when an assessment will determine what interventions can be used for the agitated patient refuses agitation. to complete an assessment? 1 point

Development What stages of development are Robert and Tyler and how will that influence your management of the scenario. 2 points

Robert 57 – Middle adult, look for sense of contribution to continuity of life. They must make their life count. Robert seems to be on the on other side of that idea, and probably because he didn’t make his life count, so he gave up. Tyler 18 - Tyler is at an age where he is trying to find himself and figure out where he belongs, and where can belong. The use of cocaine helps him temporarily get out of his depression. His behaviors could be a result of trying to fit in with his friend group.

P Ackerman, DNP, CNE, RN 2019 Simulation Learning System by Elsevier Scenario Psy 2 & 5

Culture & Diversity What sociocultural factors influence drug use, abuse and treatment? 2 points

Some kids will abuse drugs because it was passed down to them from their parents. Family history always matters when it comes to drug use. Peer pressure is also another topic, people will be pressured by their friends to do certain things just so they can stay in that group.

P Ackerman, DNP, CNE, RN 2019 Simulation Learning System by Elsevier Scenario Psy 2 & 5...