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Extra resources for Diseases: A Nursing Process Approach to Excellent Care, Fourth Edition
Monitor the patient's vital signs. • Give supplemental oxygen for 47 hypoxia-induced seizures. V. fluids for hypertension and physostigmine salicylate for respiratory or central nervous system (CNS) depression. Barbiturates (amobarbital, phenobarbital, secobarbital) • Street names: for barbituratesâ downers, barbs; for amobarbitalâ blue angels, blue devils; for phenobarbitalâ purple hearts, goofballs; for secobarbitalâ reds, red devils • Routes: ingestion, injection • Dependence: physical, psychological • Duration of effect: 1 to 16 hours • Medical uses: anesthetic, anticonvulsant, sedative, hypnotic Opioids (codeine, heroin, morphine, meperidine, methadone, opium) • Street names: for heroinâ junk, horse, H, smack; for morphineâ morph, M • Routes: for codeine, meperidine, morphineâ ingestion, • Of use: absent reflexes, blisters or bullous lesions, cyanosis, depressed level of consciousness (from confusion to coma), fever, flaccid muscles, hypotension, hypothermia, nystagmus, paradoxical reaction in children and elderly people, poor pupil reaction to light, respiratory depression • Of withdrawal: agitation, anxiety, fever, insomnia, orthostatic hypotension, tachycardia, tremors • Of rapid withdrawal: anorexia, apprehension, hallucinations, orthostatic hypotension, tonic-clonic seizures, tremors, weakness • If ingestion was recent, induce vomiting or perform gastric lavage.
The patient will demonstrate verbally and behaviorally a decrease in negative self-evaluation. • The patient will verbalize the effects of his condition on his usual roles and responsibilities. • The patient's family will verbalize how the effects of the patient's condition impact on their lives. • The patient will verbalize feelings of control over his well being. • The patient will verbalize understanding of methods to prevent drug-related complications. • The patient won't harm others. • The patient will voice feelings related to self-esteem.
Warn them that the patient will be tempted to drink again and will be unable to control himself after the first drink. Therefore, he must abstain from alcohol for the rest of his life. • Explain to the patient and family that relapses may occur. Help them negotiate a plan to help the patient if he does experience a relapse. • If the patient is taking disulfiram (or has taken it within the previous 2 weeks), warn him of the effects of alcohol ingestion, which may last from 30 minutes to 3 hours or longer.