Nclexrn Flashcards: Substance Use And Withdrawal Care

What this deck covers

This deck focuses on Substance Use And Withdrawal Care, giving you a quick way to review the definitions, rules, and examples that matter most for Nclexrn.

How to use these flashcards

Work through these flashcards in short sessions. Try to answer each prompt before flipping the card, then revisit any cards you miss until the explanation feels automatic.

Flashcard 1: Which opioid use disorder medication is a full opioid agonist dispensed in regulated treatment programs?

Answer: Methadone. It stabilizes patients by providing long-acting opioid effects in controlled environments to reduce illicit use.

Flashcard 2: Which medication class is first-line for preventing seizures in acute alcohol withdrawal?

Answer: Benzodiazepines. They enhance GABAergic inhibition, reducing neuronal hyperactivity and seizure threshold in withdrawal.

Flashcard 3: Which withdrawal syndrome is most likely to cause seizures and delirium tremens?

Answer: Alcohol withdrawal. Abrupt cessation after chronic heavy use leads to central nervous system hyperexcitability, manifesting as seizures and severe delirium.

Flashcard 4: Identify the priority concern in benzodiazepine withdrawal: seizures or diarrhea?

Answer: Seizures. Abrupt cessation lowers seizure threshold due to reduced GABA activity, posing a life-threatening risk.

Flashcard 5: What is the immediate nursing intervention for acute alcohol withdrawal with agitation and tremors?

Answer: Administer prescribed benzodiazepine. Benzodiazepines calm CNS hyperexcitability, alleviating symptoms like agitation and tremors safely.

Flashcard 6: Which assessment finding is most consistent with opioid intoxication rather than withdrawal?

Answer: Miosis with respiratory depression. Opioid receptor activation causes pupillary constriction and central respiratory center suppression.

Flashcard 7: Which medication is used for long-term relapse prevention by producing an aversive reaction with alcohol?

Answer: Disulfiram. It blocks aldehyde dehydrogenase, causing acetaldehyde buildup and unpleasant symptoms upon alcohol ingestion.

Flashcard 8: Which medication is the opioid antagonist used to reverse opioid overdose?

Answer: Naloxone. It rapidly displaces opioids from mu receptors, reversing central nervous system and respiratory depression.

Flashcard 9: Which precaution is highest priority for a patient in severe alcohol withdrawal with confusion?

Answer: Seizure precautions. Severe withdrawal increases seizure risk, necessitating protective measures to prevent injury.

Flashcard 10: What timing principle helps prevent precipitated withdrawal when initiating buprenorphine?

Answer: Start when moderate withdrawal is present. Initiating during moderate withdrawal ensures full agonists have sufficiently dissociated from receptors.

Flashcard 11: What assessment tool is commonly used to quantify severity of alcohol withdrawal symptoms?

Answer: CIWA-Ar scale. It scores symptoms like nausea, tremor, and anxiety to guide benzodiazepine dosing objectively.

Flashcard 12: Which laboratory abnormality is common in chronic alcohol use and increases bleeding risk?

Answer: Thrombocytopenia. Chronic alcohol suppresses bone marrow, leading to reduced platelet production and heightened bleeding tendency.

Flashcard 13: Which counseling point is essential for disulfiram therapy regarding alcohol-containing products?

Answer: Avoid all alcohol, including hidden sources. Even small amounts in products like mouthwash can trigger the aversive acetaldehyde reaction.

Flashcard 14: Which medication reduces alcohol cravings and blocks opioid receptors to support abstinence?

Answer: Naltrexone. By antagonizing mu receptors, it diminishes the euphoric effects and cravings associated with alcohol.

Flashcard 15: Which opioid use disorder medication is a partial opioid agonist that can precipitate withdrawal if started too early?

Answer: Buprenorphine. As a partial agonist, it can displace full agonists from receptors, inducing acute withdrawal symptoms.

Flashcard 16: Which medication helps maintain alcohol abstinence by modulating glutamate and GABA balance?

Answer: Acamprosate. It normalizes neurotransmitter imbalances in the brain post-alcohol cessation, reducing relapse likelihood.

Flashcard 17: Which infection-prevention action is required after a needlestick from a patient with unknown substance use history?

Answer: Initiate post-exposure protocol per facility policy. Substance use increases risk of bloodborne infections, requiring prompt prophylaxis to prevent transmission.

Flashcard 18: What is the most critical adverse effect to monitor after giving naloxone?

Answer: Recurrent respiratory depression. Naloxone's shorter half-life compared to many opioids can lead to re-emergence of overdose symptoms.

Flashcard 19: Which vitamin should be given before glucose in chronic alcohol use to prevent Wernicke encephalopathy?

Answer: Thiamine (vitamin B1). Thiamine deficiency in alcoholics can worsen with glucose, precipitating acute neurological damage.

Flashcard 20: Which finding suggests stimulant intoxication (cocaine/amphetamines) rather than opioid intoxication?

Answer: Hypertension with tachycardia and mydriasis. Stimulants activate sympathetic nervous system, causing elevated blood pressure, heart rate, and pupillary dilation.

Flashcard 21: Which substance withdrawal is most likely to be life-threatening due to seizures: alcohol or opioids?

Answer: Alcohol. Its withdrawal can cause severe seizures and delirium tremens, which are potentially fatal without intervention.

Flashcard 22: Which medication is preferred for acute benzodiazepine withdrawal management: taper with benzo or naloxone?

Answer: Taper with a benzodiazepine. Gradual reduction minimizes rebound hyperexcitability and seizure risk associated with sudden discontinuation.

Flashcard 23: Which assessment finding is most consistent with opioid withdrawal rather than intoxication?

Answer: Mydriasis with rhinorrhea and diarrhea. Withdrawal triggers sympathetic rebound, leading to dilated pupils and cholinergic symptoms like runny nose and loose stools.

Flashcard 24: What is the priority initial nursing action for suspected opioid overdose with respiratory depression?

Answer: Support airway and ventilation. Airway management takes precedence to address life-threatening respiratory depression and maintain oxygenation.