Chapter 15: Substance Use Disorder Treatment DrugsContent check — Pharmacology, Chapter 15: Substance Use Disorder Treatment Drugs

Read the following clinical scenario to answer the questions that follow. This case study will evolve throughout the chapter.

Daniel Nguyen is a 34-year-old client who presents to his health care provider’s office stating that he wishes for help with his prescription opioid use.

History
Opioid use disorder: takes prescription oxycodone when he can acquire it
Cigarette smoking: smokes 1 pack per day for 7 years
Major depressive disorder
Chronic back pain—developed after a workplace injury at his construction job 5 years ago

Current Medications
Duloxetine 40 mg orally daily
Oxycodone 20 mg orally as needed for pain

Based on the information above, what is a priority question for the nurse to ask Daniel?

Read the following clinical scenario to answer the questions that follow. This case study will evolve throughout the chapter.

Daniel Nguyen is a 34-year-old client who presents to his health care provider’s office stating that he wishes for help with his prescription opioid use.

History
Opioid use disorder: takes prescription oxycodone when he can acquire it
Cigarette smoking: smokes 1 pack per day for 7 years
Major depressive disorder
Chronic back pain—developed after a workplace injury at his construction job 5 years ago

Current Medications
Duloxetine 40 mg orally daily
Oxycodone 20 mg orally as needed for pain

What effects of opioid withdrawal should the nurse educate the client about that can happen if he continues taking opioids along with naltrexone?

Read the following clinical scenario to answer the questions that follow. This case study is a follow-up to Case Study Part A.

Six months after the last encounter, Daniel Nguyen, a 34-year-old client, presents to the primary care provider and reports that he has been doing well after starting therapy with buprenorphine-naloxone and reports no other opioid use. He states that withdrawal symptoms are minimal and manageable. He states that he now wishes for help with his cigarette-smoking habit.

History
Opioid use disorder: being treated with buprenorphine-naloxone
Cigarette smoking: smokes one pack per day for 7 years
Major depressive disorder

Current Medications
Buprenorphine-naloxone: 16 mg/4 mg orally daily
Duloxetine: 40 mg orally daily

Based on the information above, the nurse anticipates that the prescriber will most likely choose which medication for the client?

Read the following clinical scenario to answer the questions that follow. This case study is a follow-up to Case Study Part A.

Six months after the last encounter, Daniel Nguyen, a 34-year-old client, presents to the primary care provider and reports that he has been doing well after starting therapy with buprenorphine-naloxone and reports no other opioid use. He states that withdrawal symptoms are minimal and manageable. He states that he now wishes for help with his cigarette-smoking habit.

History
Opioid use disorder: being treated with buprenorphine-naloxone
Cigarette smoking: smokes one pack per day for 7 years
Major depressive disorder

Current Medications
Buprenorphine-naloxone: 16 mg/4 mg orally daily
Duloxetine: 40 mg orally daily

The provider prescribes varenicline for the client. When should the client discontinue use of tobacco-containing products?

A nurse is evaluating a client in the emergency department, who states that they take oxycodone chronically for cancer-related pain but forgot their medication at home while on vacation. The client is experiencing severe pain, diarrhea, piloerection, sweating, and malaise. Which of the following phenomena should the nurse tell the client they are experiencing?

A nurse is talking with a client at a primary care office, and the client states that they normally smoke a half pack of cigarettes per day but have recently stopped smoking abruptly. The client states they are physically fine, but they frequently find themselves thinking about smoking again and experiencing intense cravings to smoke another cigarette. Which of the following phenomena should the nurse tell the client they are experiencing?

What is the primary purpose of the Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) assessment instrument?

A client is brought to the emergency department via emergency services after being found in their car unresponsive to any stimuli. The nurse evaluating the client notices that they have slow, shallow breathing, are unresponsive to painful stimuli, and have pinpoint pupils. Which medication does the nurse anticipate the provider will prescribe for this client?

A nurse is evaluating a client for treatment of their opioid use disorder. They have a history of intravenous use of agents such as oxycodone and heroin. Which medication is the prescriber most likely to order to deter intravenous abuse of the medication?

A nurse is educating a client with an opioid use disorder and their parent about how to recognize the signs and symptoms of opioid overdose and when to administer naloxone. Which of the following statements should the nurse make?

A nurse is collaborating with a client with a known alcohol use disorder who has recently been prescribed disulfiram. Which clinical effect should the nurse educate the client about if they decide to consume alcohol?

A client is being admitted to the hospital for pancreatitis, and the nurse managing the client learns that the client has a previously undisclosed alcohol use disorder and has been without any alcohol for the past 2 days. Which of the following withdrawal effects would the nurse expect this client to develop?

A client is starting nicotine replacement therapy (NRT) for their nicotine use disorder. The nurse educating the client about the medication should make which of the following points?

A client is being evaluated for therapy for their nicotine use disorder. The nurse notes in their history that the client has been diagnosed with a major depressive disorder but is not currently receiving any treatment for that condition. Which of the medications used for smoking cessation would the nurse anticipate the prescribing provider will initiate to both treat the client’s depression and help with smoking cessation?