University:
Texas Lutheran University
Course:
NURS 332 | Fundamental Nursing Concepts & Practice
Academic year:

2023
Views:

281

Pages:

1
Author:

Filimon Tsegay

SUBSTANCE USE DISORDER Etiology / Risk Factors ● Genetic predisposition ● Co-occurring mental illness (e.g., depression, bipolar, PTSD) ● Trauma history / ACEs ● Poor coping skills ● Peer pressure / environment ● Lack of social support ● Chronic pain Types of Substances Commonly Encountered ● CNS depressants: alcohol, benzodiazepines ● CNS stimulants: cocaine, meth ● Opioids: heroin, oxycodone ● Hallucinogens / cannabis ● Polysubstance use Assessment Data Subjective: ● Cravings, guilt, shame ● Denial or minimization ● "I can quit anytime" ● Depression, anxiety, paranoia Objective: ● Signs of withdrawal (e.g., tremors, sweating, tachycardia) ● Slurred speech, poor hygiene ● Needle marks / track lines ● Malnutrition, liver dysfunction ● Defensive or manipulative behavior ● ● ● ● ● ● Definition Maladaptive pattern of substance use leading to clinically significant impairment or distress, with features such as impaired control, social impairment, risky use, and physiological indicators (tolerance, withdrawal). ● ● ● ● ● Expected Outcomes Patient safely detoxes without complications Engages in treatment and group therapy Identifies triggers and coping strategies Verbally expresses motivation to remain sober Participates in discharge planning for outpatient support ● ● ● ● Nursing Diagnoses ● Ineffective coping ● Risk for injury ● Risk for self-directed or other-directed violence ● Disturbed thought processes ● Knowledge deficit ● Impaired social interaction 1. 2. 3. 4. 5. 6. 7. Patient Education Nature of addiction as a chronic disease Avoid triggers Use of medications in relapse prevention Importance of therapy and peer support Long-term consequences of substance use Aftercare and discharge planning Medications (TREATMENT) Alcohol use: benzodiazepines (for withdrawal), disulfiram, naltrexone Opioid use: methadone, buprenorphine, naloxone (for overdose) Cravings: acamprosate, naltrexone Co-occurring disorders: SSRIs, antipsychotics Prioritized Nursing Interventions Ensure safety: monitor for withdrawal symptoms, seizures, agitation Maintain therapeutic boundaries Administer medications as prescribed (e.g., benzos for alcohol withdrawal, methadone, buprenorphine) Assess suicide/self-harm risk Promote group therapy participation (e.g., NA/AA meetings) Use motivational interviewing techniques Encourage journaling, stress management, and relapse prevention planning

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