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Case Scenario Bonnie R., a 19-year-old mother of two, arrives in the emergency department with her 18-month-old son, Billy. She gives you a vague history of Billy being pushed off the bed by his older brother about 3 or 4 days ago. Since then Billy has been irritable and fussy. He refuses to eat and cries “all the time.” Whenever Billy tries to walk, his left leg crumples and he falls. Because of his constant fussing, Bonnie admits to having “smacked him” yesterday so he would “stop screaming.” 11. What information in Billy’s history provides you with a clue to the possibility of child abuse? _________________________________________________________________________________ 12. What information should your physical assessment include? _________________________________________________________________________________ 13. What is the first priority of care for Billy at this time? _________________________________________________________________________________ As you assist the physician in placing Billy in traction, you become angry at the thought of Billy having to endure so much unnecessary pain. By the time Billy is finally settled, you are absolutely furious with Billy’s mother. 14. How do you cope with these emotions and still remain therapeutic with Billy and his mother? __________________________________________________________________________________ __________________________________________________________________________________ Study Guide Chapter 27: Inward-Focused Emotions: Suicide Identify the terms that best describe the behaviors characterized in the following statements: 1. __________________ Jerry smokes cigarettes, drives his motorcycle too fast, and likes to feel the thrill of being chased by the police. 2. __________________ Heather repeatedly scratches herself until she bleeds because the pain “lets me know I’m still here.” 3. __________________ Sam states that he will attempt suicide again, but he has not acted so far. 4. __________________ Mary overdosed with sleeping medications because she “is tired of fighting.” 5. __________________ Yesterday, John gave his cherished car to his best friend. Last night he died from a gunshot wound to the head. Indicate if the following statements are true (T) or false (F): 6. _____ Suicidal thoughts or intentions can exist in clients with any medical or mental health disorder. 7. _____ Suicide rates are lower in people who use drugs or alcohol. 8. _____ All suicidal persons are depressed. 9. _____ People who talk about suicide will not attempt to do it. 10. _____ It is harmful to discuss suicide with clients. Case Scenario David has recently lost his job, custody of his children, and his car because he was unable to make the monthly payments. He is being admitted following a week-long drinking binge. He has repeatedly stated that he would be better off dead. 11. The first priority for this client is: _________________________________________________________________________________ 12. It has been assessed that David is a high suicide risk. The type of observation that he requires is called: _________________________________________________________________________________ 13. Staff members attempt to make a “no-self-harm contract” with David. Explain a no-self-harm contract. _________________________________________________________________________________ 14. David’s caregivers help him to explore coping mechanisms that were successful in the past. The purpose of this is to: _________________________________________________________________________________ Study Guide Chapter 28: Substance-Related Disorders 1. Physical dependence on a drug that is taken despite the problems associated with its use is called __________________. 2. __________________ occurs when an individual who was previously drug free returns to substance-abusing behaviors. 3. When a person is not using an addictive substance, he or she is practicing __________________. 4. __________________ occurs when increasingly larger amounts of a substance are required to produce the desired effect. 5. The incidence of __________________ rises when women consume alcohol during pregnancy. 6. Older adults frequently abuse __________________. Identify the type of substance abused, and circle the correct answer: 7. Jerry has “chugged” large amounts of the substance and now is beginning to show signs of respiratory failure. a. antibiotics b. amphetamines c. alcohol d. inhalants 8. The physical assessment of Maria reveals constricted pupils, euphoria, and drowsiness. a. PCP (phencyclidine) b. heroin c. cocaine d. marijuana 9. After injecting or inhaling it, Jamie experiences intense feelings of well-being that last for less than an hour. a. alcohol b. acid c. caffeine d. cocaine 10. Stan had a flashback 2 weeks after taking: a. alcohol b. acid c. caffeine d. cocaine 11. Amber is unable to sit still, her pulse rate is greater than 120 beats/min, and she is constantly talking and fidgeting. a. alcohol b. acid c. amphetamines d. alfalfa Study Guide 12. Larry feels very hot, removes his clothes, and becomes very aggressive. a. bath salts b. cannabis c. cocaine d. caffeine List three ways in which nurses and other care providers can act as therapeutic agents when caring for individuals with substance abuse problems: 13. __________________________________________________________________ 14. __________________________________________________________________ 15. __________________________________________________________________

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