Free Essay Example on Reaction to Drug Dependent Patients

Introduction

Drug dependence means that the patient relies on the drug to function. As a nurse, my reaction would be different when dealing with a drug-dependent patient because each drug has different effects on the body. The quantities also differ as well as the severity and illness trajectories of every patient. For instance, I would fear the violent nature of cocaine-dependent patients than those relying on marijuana because of numerous cases of violence.

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Heroin Use Among Teenagers

The trend in heroin use among teenagers is increasing despite the various platforms of awareness of drug use. Recent information from the National Institute on Drug abuse on the use of opioids indicates that teenagers are increasingly abusing this drug. However, the overall trend over the last five years has declined only for 10th to 12th graders (NIDA, 2020). Above this age, most young people tend to explore heroin use among other opioids hence increased risks such as addiction.

Concept of Tolerance

Tolerance is the act of resorting to the diminished use of a drug other than the repeated use. People like Ms. Seymour can develop acute tolerance because the length of exposure to the drug is relatively short. Ms. Seymour can tolerate the amounts of heroin taken to keep her blood pressure and heart rate in check.

Signs and Symptoms

After taking heroin, the short-term physical and behavioral-psychological signs and symptoms include euphoric rush, severe itching, slowed heart rate, nausea, vomiting, drowsiness, clouded thinking, and flushed skin (Darke, 2016). Others include anxiety, headache, shortness of breath because of irregular heart rate, headache, chest pains, and tremors. The severity of these signs and symptoms are dependent on the dosage of heroin in the blood. Behaviorally, she would display a change in behavior, keep heroin paraphernalia, and constantly steal money.

Emergency Care

The emergency care for heroin overdose at the emergency department is the administration of Naloxone. This drug has no agonistic activity and is a pure antagonist of opiate receptors. In addition to being relatively safe, Naloxone can be given intramuscular, intravenous, or subcutaneous (Lewallen et al., 2013). The drug can work within minutes of administration, and then the dosage stopped one the patient is awake. The same drug or its combination with Buprenorphine can be used for long-term care, but the dosage varies depending on the level of use.

Medical Interventions

The withdrawal symptoms that can be observed from Mr. Garmond in the emergency department include autonomic hypersensitivity, perceptual disturbances, seizures, increased anxiety and agitation, nausea, and vomiting. In the emergency department, the first method to deal with this situation is patient stabilization done through securing the airways, conducting fluid resuscitation, and measuring blood glucose levels. Dextrose, Naloxone, Benzodiazepines, and Barbiturates can be administered for treatment (Wolf et al., 2020). Detoxification can also be applicable in this case.

Treatment Alternatives

After he has been detoxified, the patient is expected to have reduced or stopped shaking, confusion, convulsions, and hallucinations, among other symptoms. Other pharmacological treatment methods that can apply to his case include the use of Gabapentin because of its anticonvulsive and sedative properties, administration of anti-epileptic drugs such as Divalproex, phenytoin, and carbamazepine, and lastly, adjunctive medication (Wolf et al., 2020). I would explain to Mr. Garmond that Alcoholics Anonymous (AA) groups are important gatherings that help alcoholics to accept themselves, share their addiction struggles, and set them on a path to redemption. Community AA groups are many in my community, such as the Veterans AA, which can help him in this situation.

Cherie is brought to the emergency department after slashing her wrist with a razor. She has previously been in the emergency department for drug overdose and has a history of addictions. Cherie can be sarcastic, belittling, and aggressive to those who try to care for her. When the psychiatric triage nurse comes in to see her, Cherie is initially adoring and compliant, telling him, “You are the best nurse I’ve ever had, and I truly want to change.” But when he refuses to support her request for diazepam (Valium) and meperidine (Demerol) for “pain,” she yells at him, “You are a stupid excuse for a nurse. I want to see the doctor immediately.” Cherie has a borderline personality disorder.

Defense Mechanism

The defense mechanisms employed by Cherie are idealization and devaluation. Idealization portrays someone as extremely good qualities, while devaluation involves an extreme exaggeration of another person or attributing them as flawed or worthless (Zanarini et al., 2009).

Conclusion

A nurse should be able to understand the complexities of bipolar personality disorder for them to respond therapeutically without emotions like frustrations, anger, and fear. Improved education and training can help them become rational, uphold a positive attitude, have a moral sense of commitment, and perceive the patient as a challenge that they need to overcome (McGrath & Dowling, 2012). Any response to a patient like Cherie should not be based on manipulation, but a subjective assessment of the patient's needs and provision of what can be medically appropriate.

References

Darke, S. (2016). Heroin overdose. Addiction, 111(11), 2060-2063.
https://doi.org/10.1111/add.13516

Lewallen, L., Bartlett, R., Brown, L., & Wright, T. (2020). Harm Reduction: Compassionate Care Of Persons with Addictions. PubMed Central (PMC). Retrieved 8 August 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4070513/.

McGrath, B., & Dowling, M. (2012). Exploring Registered Psychiatric Nurses' Responses towards Service Users with a Diagnosis of Borderline Personality Disorder. Nursing Research And Practice, 2012, 1-10. https://doi.org/10.1155/2012/601918

NIDA. (2020). Monitoring the Future Survey: High School and Youth Trends DrugFacts. https://www.drugabuse.gov/publications/drugfacts/monitoring-future-survey-high-school-youth-trends

Wolf, C., Curry, A., Nacht, J., & Simpson, S. (2020). Management of Alcohol Withdrawal in the Emergency Department: Current Perspectives Open Access Emergency Medicine, Volume 12, 53-65.
https://doi.org/10.2147/oaem.s235288

Zanarini, M., Weingeroff, J., & Frankenburg, F. (2009). Defense Mechanisms Associated With Borderline Personality Disorder. Journal Of Personality Disorders, 23(2), 113-121.
https://doi.org/10.1521/pedi.2009.23.2.113