Substance Use Assessment Quiz

Tobacco, Nicotine, ETOH, Marijuana

• Differentiate between common substances causing negative health outcomes in the U.S.
• Identify how a nurse can intervene using the nursing process for clients who use, abuse, or are addicted to substances.

Alcohol

• Risk Factors: Alcohol use disorder, liver disease, heart disease, cancer (mouth, liver, breast), stroke, brain damage.
• Nursing Interventions:
  • Assess using screening tools (CAGE, AUDIT).
  • Educate on the effects of excessive alcohol use.
  • Offer resources (counseling, support groups).
  • Refer for alcohol treatment if necessary.
• Nursing Process (ADPIE):
  • Assessment: Gather alcohol use history, screen for alcohol use disorder.
  • Diagnosis: Impaired coping, risk for injury.
  • Planning: Set goals (reduce alcohol consumption).
  • Intervention: Offer brief intervention, educational materials, and resources.
  • Evaluation: Track progress with follow-up.

Tobacco/Nicotine (Including E-cigarettes)

• Risk Factors: Lung cancer, heart disease, stroke, COPD, respiratory infections, secondhand smoke risks.
• Nursing Interventions:
  • Assess tobacco use and readiness to quit.
  • Discuss nicotine replacement therapies and cessation aids.
  • Provide resources.
• Nursing Process (ADPIE)
  • Assessment: Identify smoking history and e-cigarette use.
  • Diagnosis: Risk for respiratory issues, ineffective health management.
  • Planning: Set a quit date and provide behavioral therapy options.
  • Intervention: Motivational interviewing, education on smoking cessation methods.
  • Evaluation: Monitor for relapse and provide ongoing support.

THC/Marijuana

• Risk Factors: Impaired memory, concentration, motor coordination, lung damage, mental health issues (anxiety, paranoia), marijuana use disorder.
• Nursing Interventions:
  • Assess marijuana use (frequency, impact on daily life).
  • Discuss potential risks, especially for teens and clients with mental health conditions.

Prevalence of Substance Use in the U.S.

• Alcohol: 56% of U.S. adults drink regularly
• Tobacco: 14% of U.S. adults smoke
• Nicotine (e-cigarettes): 20% of teens use e-cigarettes (2023)
• THC/Marijuana: 18% of U.S. adults use marijuana regularly.
• CBD: 26% of U.S. adults have used CBD.

At-Risk Populations (for substance abuse)

• Alcohol: Men, younger adults, low socioeconomic status, and those with mental health disorders.
•  Tobacco: Lower-income individuals, those with mental health issues, and the LGBTQ+ population.
•  Nicotine (e-cigarettes): Adolescents, young adults, and those in social circles where vaping is common.
•  THC/Marijuana: Young adults (particularly in states where marijuana is legal). People with chronic pain, sleep disorders, and/or anxiety disorders.

CAGE & SBIRT

• CAGE: Questionnaire used to identify potential alcohol use disorder.
• SBIRT: Screening, Brief Intervention, and Referral to Treatment. Uses AUDIT or CAGE to assess alcohol use, offers counseling to reduce or stop drinking, and refers to treatment programs.

Short- and Long-Term Effects of Substance Use

• Alcohol: Short-term: Impaired judgment, accidents, violence, dehydration; Long-term: Liver disease, heart disease, stroke, cancer
• Tobacco: Short-term: Increased heart rate, coughing; Long-term: COPD, lung cancer, heart disease, stroke
• Nicotine: Short-term: Increased heart rate, addiction; Long-term: lung disease, cardiovascular issues
• THC/Marijuana: Short-term: Impaired coordination, drowsiness; Long-term: Cognitive impairment, lung damage, mental health issues
• CBD: Short-term: Drowsiness, dry mouth; Unknown long-term effects, potential liver damage, drug interactions

Motivational Interviewing Techniques

• Open-ended questions: Encourage reflection on their behavior and feelings.
• Affirmations: Acknowledge and reinforce client's strengths.
• Reflective listening: Demonstrate understanding by reflecting the client's thoughts.

General Nutrition Concepts

• Adequacy: Enough nutrients (vitamins, minerals, fiber).
• Moderation: Avoid excess of unhealthy components (added sugars, saturated fats, sodium).
• Balance: Include variety of foods (fruits, vegetables, grains, proteins, dairy).
• Variety: Eat a diverse range of foods for nutrient sufficiency.

Cultural Intelligence/Racism

• Importance of cultural intelligence from various perspectives (patient, administrator, researcher, provider, family).
• How Cultural and Linguistic Services relate to health disparities.
• How to protect someone with unique cultural considerations, such as non-English speakers.
• Social determinants of health impacting health disparities.
• Discuss the role of ableism and its impact on health disparities.

Trauma-Informed Care

• Definition: Recognizes trauma's impact, creates safe, supportive environments, and avoids re-traumatization.
• Importance of trauma awareness and response in healthcare.
• Nurse's role in trauma-informed care, including screening, trauma-sensitive language, and policies that prevent re-traumatization.
• How to encourage communities to be trauma-informed.

Resilience

• Understanding of resilience as the ability to recover from trauma.
• Traits that support resilience: strong social support, self-regulation, problem-solving, optimism, and a sense of purpose.
• Ways to strengthen resilience: supportive relationships, coping strategies, promoting physical and mental well-being, and community engagement.

Levels of Prevention

• Primary: Prevents disease/injury before occurring (vaccination, health education).
• Secondary: Detects and treats a disease early (screenings).
• Tertiary: Manages and reduces the impact of a disease (rehabilitation).

Health Screening

• Objective: Identifying individuals at risk for diseases, enabling early intervention.
• Types: Universal, targeted.
• Advantages: Early detection, improved outcomes, reduced healthcare costs.
• Disadvantages: False positives, overdiagnosis, psychological distress.
• Sensitivity/Specificity: Ability of a test to correctly identify those with/without a disease.

Models/Theories (for health promotion)

• Ecological Model: Views health as multi-level interactions (individual, interpersonal, institutional, community, public policy).
• Health Belief Model: Focuses on individual perceptions of risk, severity, benefits, and barriers.
• Self-Efficacy: Individual's belief in their ability to act.
• Transtheoretical Model (Stages of Change): Behavior change as a process.
• Theory of Reasoned Action/Planned Behavior: Focuses on intentions and perceived control.

Nurse Roles in Health Promotion

• Implement evidence-based plans using ecological models, with considerations of individual needs, cultural backgrounds, and resources.

Health Promotion for specific populations.

• Include considerations for cultural and linguistic appropriateness, and the developmental needs of the population in the plans.

Prenatal/Pregnancy

• Assess physical and mental health, and provide counseling as needed regarding their concerns. Education should also include pregnancy-related resources, advice, and support.
• Include considerations for different population groups such as teens, women over 35 etc.

Intrapartum/Postpartum

• Nurses are instrumental in monitoring for complications and providing support for newborn care. This includes physical care, emotional needs as well as nutrition and wellness support.