Inflammation : Chemical mediators
Chemical mediators Histamine Stored in granules of basophils, mast cells, platelets Causes vasodilation and increased capillary permeability Serotonin Stored in platelets, mast cells, enterochromaffin cells of GI tract Causes vasodilation and increased capillary permeability like histamine. Stimulates smooth muscle contraction Kinins (e.g., bradykinin) Produced from precursor factor kininogen as a result of activation of Hageman […]
Inflammation : Cellular response
Cellular response Blood flow through capillaries in area of inflammation slows as fluid is lost and viscosity increases Neutrophils and monocytes move to inner surface of capillaries and then migrate through capillary wall to site of injury Chemotaxis Directional migration of WBCs along concentration gradient of chemotactic factors Mechanism for accumulating neutrophils and monocytes at […]
Inflammation : Vascular response
Inflammation Sequential response to cell injury that: Neutralizes and dilutes inflammatory agent Removes necrotic materials Establishes an environment suitable for healing and repair Inflammatory response can be divided into Vascular response Cellular response Formation of exudate Healing Vascular response After cell injury, arterioles in area briefly undergo transient vasoconstriction After release of histamine and other […]
Health Promotion
Health Promotion Prevention Teach about negative effects Provide support Early detection Initiate brief interventional techniques Refer for treatment Gerontologic Considerations Older adults are often unaware of their substance use problems Difficult to recognize Don’t fit the image of users Symptoms can mimic medical conditions i.e. liver damage and cardiovascular, GI, and endocrine problems Use may […]
Nursing Management Substance Use
Nursing Management Substance Use Nursing Assessment Screening, Brief Intervention, and Referral to Treatment (SBIRT) Screening for problems using standardized screening tools Brief intervention or teaching about consequences of use and abuse Referral for further treatment Determine when substance last used Assess for withdrawal Notify HCP of polysubstance use Mental health disorders Blood work Nursing Diagnosis […]
Inhalants
Inhalants Household and workplace products contain chemicals with psychoactive properties when inhaled Rapidly absorbed and reach CNS quickly Most are depressants Long-term use can result in brain damage Cannabis THC (tetrahydrocannabinol) a key ingredient in cannabis causes psychoactive effects Low to moderate doses produce alcohol-like effects Long-term use has cardiopulmonary and mental health effects Legalization […]
Depressants
Depressants Rapid development of tolerance and dependence Commonly used with alcohol Commonly types used: Sedative-hypnotics Barbiturates Benzodiazepines Barbiturate-like drugs Depress CNS Tolerance develops to drug’s effects but not brainstem-depressant effects Opioids Misuse of illegal street drugs and prescription opioids Cause sedation and analgesia Frequently abused Toxicity Unintentional overdose occurs frequently Death can occur from CNS […]
Stimulants
Stimulants Highly addictive Increase cardiac activity Excite CNS by increasing neurotransmitters Norepinephrine Serotonin Dopamine Toxicity Sympathetic overdrive Can be fatal No antidote Emergency management is based on clinical manifestations Supportive care for agitation and cardiovascular symptoms Withdrawal Not an emergency Supportive care Quiet environment Sleeping and eating at will Suicide precautions if indicated Assessment findings […]
Alcohol Withdrawal Delirium
Alcohol Withdrawal Delirium Serious complication Can occur 2-3 days after the last drink Lasts 2-3 days Risk increases with greater alcohol dependence Manifestation Interprofessional Care Disorientation Visual, tactile, or auditory hallucinations Seizures Continued use of benzodiazepines Carbamazepine (Tegretol) or valproate (Depakote) to treat seizures Antipsychotic agents e.g. chlorpromazine (Thorazine), haloperidol (Haldol) Chlordiazepoxide (Librium) if psychosis […]
Manifestations – Interprofessional Care
Manifestations Interprofessional Care Agitation Anxiety Increased Heart rate Increased BP Sweating Nausea Tremors Insomnia Hyperactivity Benzodiazepines e.g. lorazepam (Ativan) or midazolam (Versed) to prevent seizures and delirium Thiamine to prevent Wernicke-Korsakoff syndrome Multivitamins e.g. folic acid, B vitamins Magnesium sulfate to treat low serum magnesium IV glucose solution to treat hypoglycemia β-blockers (e.g. propranolol) or […]