NUR 410 Nursing Concepts Synthesis Exam 4 (Psych, Critical Care, Leadership, & Community) Review Questions and Answers

How do we manage alcohol withdrawal? -Using CIWA to assess -Delirium tremens 2-3 days -We want safety precautions (Seizure, falls, etc.) -Aspiration risk for these patients -Medications used to treat withdrawal are benzo's and other meds (diazepam, chlordiazepoxide & clonidine, carbamazepine) What are the causes, symptoms, and treatment plans for Serotonin Syndrome? -Causes: Toxic level of serotonin related to anti-depressants, Use of OTC meds like St. John's Wort, and Inadequate time to flush meds out before starting a new one wit serotonin reuptake/increase -Symptoms: Mental confusion, difficulty concentrating, abdominal pain, diarrhea, agitation, **fever**, anxiety, hallucinations, **hyperreflexia**, incoordination, diaphoresis, tremors -Treatment: Starts symptomatic treatment (Blocking serotonin receptors with cyprohepatadine, treat muscle rigidity with benzos, anticonvulsants for safety, cooling blankets, artificial ventilation), hold medications once symptoms start What are the guidelines when it comes to using restraints? -Used only when other interventions have failed -Doctor's order required, in emergency order can be given afterwards, and a new order is needed each time What are the guidelines when it comes to monitoring restraints? -Monitor VS, I&O, assess mental status, pain, and injuries -Clearly stated expectations for release of restraints -Documents condition q 15-30 minutes -Maximum time for 18 years and up is 4 hours; 9 to 17 years is 2 hours; 8 years and under is 1 hour maximum What is Disulfiram? Alcohol deterrent maintenance/aversion therapy that is started after withdrawal is completed -liver function should be monitored on this drug -Patient should read labels as they cant have anything with alcohol as an in