PMHNP Board Review Exam (2023) with complete solutions

Positive Romberg Sign (r/t etoh) loss of balance that occurs when closing the eyes ETOH withdrawal delirium may result in? Seizures or death DSM Severity for ETOH Mild = 2-3 sx Moderate = 4-5 sx Severe = >= 6 sx DSM ETOH Remission Criteria Early = >3 mos & <12 mos Substantial Remission = >12 mos Screening & Early Intervention scale for SUD SBIRT Screening, Brief Intervention & Refereal to Treatment CAGE Cut down Annoyed Guilty Eye-Opener >=2 is clinically significant Labs for AUD ETOH/SUD Blood & urine BAC Ele. AST, ALT, MCV, CDT (Carb deficit transfer) Dec. Hgb, B12, folic acid ETOH W/D Sx Most common = tremors (w/i hours of cessation) Ele. b/p. tachy, n/v, poss. hyperthermia Sx of ETOH W/D Emergency Hallucinations = 7 - 48 hours DTs - 48 - 72 hours, peaks on 4th day, can last for 2 weeks CIWA Clinical Institute Withdrawal Assessment 0-8 Support &Monitoring w/o meds! (NO meds unless >=8) 8-14 = Pharm Intervention 15 = IMMEDIATE Pharm Int! Disulfiram (Antabuse) Dosage for ETOH Usually 250 mg/day NO perfumes or mouthwash! Meds Used for ETOH W/D Sx including Seizures Benzos & Carbamazepine (Tegretol) Vitamin to be given during ETOH detox Thiamine >300 mg/day CRAFFT SUD screening tool for adolescents (12-21) COWS Clinical Opiate Withdrawal Scale 5-12 = mild 13-24 = moderate 25-36 = moderately severe >36 = severe withdrawal Meds used for Opiod Detox & Maintenance Buprenorphine (Suboxone) Naloxone (Naltrexone) Methadone Clonidine (use with care! may mask VS changes & inc. seizure risk!) Phenobarbital Cannabis W/D Symptoms Timeline Sx begin w/in 24 - 48 hours Peak 4 - 6 hours Duration 1 - 3 weeks