Substance Abuse and Abuse Q 2
The newly hired nurse at Nurseslabs Medical Center is assessing a client who abuses barbiturates and benzodiazepine. The nurse would observe for evidence of which withdrawal symptoms?
A. Respiratory depression, stupor, and bradycardia
B. Anxiety, tremors, and tachycardia
C. Muscle aches, cramps, and lacrimation
D. Paranoia, depression, and agitation
Correct Answer: B. Anxiety, tremors, and tachycardia
Barbiturates and benzodiazepine are CNS depressants; therefore, withdrawal symptoms are related to CNS stimulation caused by the rebounding of neurotransmitters (norepinephrine). Symptoms include increased anxiety, tremors, and vital sign changes (such as tachycardia and hypertension). Chronic abusers can develop severe withdrawal symptoms within 8 to 15 hours of cessation. Symptoms include restlessness, tremors, hyperthermia, sweating, insomnia, anxiety, seizures, circulatory failure, and potentially death.
Option A: Respiratory depression, stupor, and bradycardia are typically associated with an overdose—not withdrawal—of barbiturates or benzodiazepine. Symptoms of barbiturate toxicity vary from case to case, but commonly include difficulty thinking, decreased level of consciousness, bradycardia or rapid and weak pulse, poor coordination, vertigo, nausea, muscle weakness, thirst, oliguria, decreased temperature, and dilated or contracted pupils. Fatal cases are marked by coma, hypotension (low blood pressure), and respiratory depression (decreased efforts to breathe) evidenced by cyanosis and hypotension
Option C: Muscle aches, cramps, and lacrimation are most commonly associated with withdrawal from opiates. According to Diagnostic and Statistical Manual of Mental Disorders (DSM–5) criteria, signs and symptoms of opioid withdrawal include lacrimation or rhinorrhea, piloerection “goose flesh,” myalgia, diarrhea, nausea/vomiting, pupillary dilation and photophobia, insomnia, autonomic hyperactivity (tachypnea, hyperreflexia, tachycardia, sweating, hypertension, hyperthermia), and yawning.
Option D: Paranoia, depression, and agitation are usually associated with withdrawal from CNS stimulants, such as amphetamines or cocaine. Central nervous system (CNS) stimulants like cocaine and amphetamine can also produce withdrawal symptoms. Like opioids, the withdrawal symptoms are mild and not life-threatening. Often the individual will develop marked depression, excessive sleep, hunger, dysphoria, and severe psychomotor retardation but all vital functions are well preserved. Recovery is usually slow, and depression can last for several weeks.