1. Identify two questions the NP should ask during the assessment and why? (10pts) Answer: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) divides the substance-related disorders (SRDs) into two sub-categories, namely, substance-induced disorders (SIDs) and substance use disorders (SUDs) (McCarron, Xiong, & Bourgeois, 2009). SIDs relates to the medical conditions that are caused by the use of substances. These conditions include intoxication and withdrawal syndromes. SUDs are defined as a patient’s recurrent behavior to use alcohol and/or drugs that cause clinical and functional impairment, for example, malfunction at school, work, home, and health problems (McCarron, Xiong, & Bourgeois, 2009). Mr. HR’s …show more content…
However, for the purpose of answering this question, I would ask the following from the patient. First is a brief screening questionnaire based on CAGE-AID, as follows: Have you ever felt that you should cut down the drug/alcohol use? Have people annoyed you by criticizing your drug/alcohol use? Have you felt guilty about your drug/alcohol use? Have you ever used drugs/alcohol first thing in the morning? If one or more answers are confirmed, then further assessment is required (McCarron, Xiong, & Bourgeois, 2009). CAGE-AID questionnaire is not only easy to administer, but also has a very good sensitivity and specificity to assess severity of drug abuse (Leonardson et al. 2005). Second, it is important for the clinician to assess and to ask the question to the patient that if the car accident was related to the any types of substance use. History of substance use and/or positive drug screen exhibit poor judgment. It indicates Mr. HR is at a risk of injury and remission related to excessive consumption of …show more content…
Each individual’s culturally based response to pain is divided into two categories: stoic and emotive (Marcia, 2011). Patients with stoic character response to pain in a less expressive way. They are more tending to bear with the pain and withdraw socially. On the other hand, emotive patients’ response to pain tends to be more verbalizing their expressions of pain. They like to have people around them and also react to their pain as well as to validate their discomfort (Marcia, 2011). A broad generalization is that patients from Hispanic (Mr.HR is Hispanic background), Mediterranean and Middle Eastern background are more likely to be emotional and expressive about their pain. Other groups, patients from Asian, Scandinavian and Northern European cultures are considered to be more stoic (Marcia, 2011). As a provider, we can use cultural factors to understand the patient’s reaction to pain, but we have to keep in mind that we cannot expect that the same behaviors or beliefs apply to everyone in the same culture (Marcia,
There is no doubt that there is a prevalence of substance abuse throughout several age groups. To a certain extent, a society is faced with the reality of controlling substance abuse. Or allow it run rampant throughout the community. Often times, we hear and read about the level of substance abuse among teen, young adults and mid-aged
“Substance use disorders” or “substance-related disorders” are intended synonymously and are used interchangeably when referring to the broad category of addiction to psychoactive substances. Additionally, the word “drug” should be considered in the context in which it appears and can refer to alcohol specifically and/or other psychoactive substances such as cocaine or heroin etc. Again, this is because of the large overlap within the broader category of substance use and the high prevalence of polysubstance use. For the sake of clarity, “drug” as used in North America to generally refer to any illicit or controlled substance has been avoided. Instead, “medication” will be used to denote a prescribed substance used to treat physical symptoms. However, many legally prescribed medications (such as morphine) can and are abused and have addictive quality, making them just as devastating as “street drugs” or alcohol (Compton & Volkow, 2006).
The DSM–5 incorporates the two DSM–IV syndromes, alcohol abuse and alcohol dependence, into one disorder - alcohol use disorder (AUD). AUD has sub-classifications of minor, moderate, and severe. A person who meets one or more of the criteria for abuse within a 12-month period would receive the “abuse” diagnosis. Anyone with three or more of the “dependence” criteria (see items 5 through 11) during the same 12-month period would receive a “dependence” diagnosis ( American
During the state of SUD it is question whether the individual suffering from such a disease should be held accountable for their actions. Another distinguishing factor between SUD and abuse is that SUD are not static entities but rather evolve over time (Doweiko, 2015). This evolution or rather stages are ranged from 0-4 which include total abstinence to middle to late stage addiction. SUD must also meet certain criteria’s in the DSM-5 manual. There are 4 general categories to determine if an individual suffers from SUD (Doweiko, 2015). The categories consist of impaired control over substance, multiple attempts to quit, activities center around getting substance, using, or recovering from using, and pharmacological effects of the drug. Manifestations, spiritual, vocational, primary disease, and potential to be fatal is also considered in the diagnosis criteria of SUD. Substance abuse on the other is used when individual uses a substance or compound for no medical reason or the substance is used in excess (Doweiko, 2015). Abuse has no physical dependency from the chemical, has no automatic physical
The purpose of this paper is to explore the effects of the Chinese culture on pain perception, responses and management. Cultural backgrounds can have a significant role in how a person perceives and copes with their pain, many studies have identified the vast difference between cultures. “Culture shapes many aspects of the experience of pain, including pain expression, lay remedies, social roles, expectations, perceptions of the medical system, when/how/where to seek care, healthcare practices, illness beliefs and behaviors, and receptivity to medical care interventions” (Campbell, 2012)
Cultural aspects of holistic assessment is relevant in the provision of nursing care as it provides the care team with an overview of cultural needs of the patient as well as providing information in which the patients’ health problems have arisen. Culture is defined as values, beliefs, artifacts, behaviors, attitudes and customs influencing and regulating interactions between members of a social group (Stein-Parbury 2010: 91; Johnstone 2006: 67). It is the nurses responsibility to adhere to the ANMC, competency 2.3, ‘accepts individuals/groups to whom care is provided regardless of race, culture, religion, age, gender, sexual preference, physical or mental state’ (ANMC 2006, p. 4). Kozier & Erb (2012: 360) discuss that cultural sensitivity, appropriateness, competency and safety are all factors that are required to be taken into consideration so that the patient can be provided with the best possible health care. Kozier & Erb (2012: 360) also explain that conflicts in health care have been apparent due to cultural misunderstandings. An example of a cultural misunderstanding is the level of pain. In some cultures, it is normal to dramatically express ones level of pain whereas in other cultures people do
Journey’s intake unit completes all initial assessment to assess client for different level of care and accurately assign them to the most appropriate unit. The different level of care ranged from intensive inpatient care unit to medication only. As a practicum student, I worked in the outpatient services unit. The assessment was completed via an online program with an intake staff and the client, usually a week or two before the first scheduled appointment with a clinician. Therefore, once a client is assigned to me, I have access to review their file. The assessment are usually completed in a brief model format, and as the clinician assigned to work with a client, I am expected to use the first two sessions of therapy
JCAHO (2011) also stated that patients and their families needed to be educated about pain and how the patients’ pain is going to be managed. Every patient perceives and exhibits pain in a different manner and if nurses do not assess the patient thoroughly they can miss it. For instance, Engebretson et al. (2006) acknowledged that, patients manifest pain in different ways and this resulted in nurses performing an inadequate assessment of their patients’ pain. Also, Engebretson et al. recognized that patients often conceal their pain because they do not want to be viewed by staff as complainers or addicts, and if patients decide to speak up the nurses frequently view their patients’ statements from their own cultural, moral and ethical belief system and not their patients which leaves the patients’ pain untreated.
“Pain is a universal condition. At some time, each person will experience pain from illness or injury. Pain isn 't only a physical experience; it also has an emotional component that may trigger behaviors that play an important role in how a patient 's pain is perceived by others (Yvonne, 2009)”. Pain can create a great impact on person’s life. In this paper, I will focus on the effects of Chinese culture on pain perception, responses, and management as well as how their ethnic differences and ethnic background helps them to
A “Substance Use Disorder” is new to the DSM-5. Previously, the terms “abuse” and “dependence” where used instead. In general, the DSM-5 considers a Substance Use Disorder to be recurrent drug use that causes impairment and continued use despite substance use related problems. The DSM-5 also focuses on how substance use causes a change in brain functioning. The change is primarily responsible for intense drug cravings, as well as repeated relapses. Finally, the DSM-5 divides the criteria for Substance Use Disorder into four groupings: impaired control (Criteria 1-4), social impairment (Criteria 5-7), risky use (Criteria 8 and 9), and pharmacological criteria (Criteria
Substance abuse is the harmful or dangerous use of any psychoactive substances including drugs, alcohol and even tobacco. The term ‘Substance Abuse’, as understood today was first used in 1987’s DSM-IIIR, before that social & cultural factors were not considered. Even with that change, many Americans still today consider drug and alcohol abuse to be moral weakness or character defect.
Substance abuse disorders is easily defined when an “individual continues to use the substance despite experiencing negative consequences from their use. These negative consequences can include health problems; difficulties in their family, work, and social life; and financial and legal problems. They are said to be dependent on the substance when,” in addition to theses negative consequences, they build tolerance and experience withdrawal if they stop using the drug” (Martin, 2007, p. 265). Substance abuse dates back to the early Americans colonies with beer that was brought over by the pilgrims and more popularly the ratification of the Constitution to prohibit the use of alcohol
Patients, who don’t manage the cancer pain properly, more likely experience greater pain. In order to better help and understand patients of different ethnic groups and cultures, it would be good for care providers to research and learn more about those people’s backgrounds to open the door to more specific questions to patients which will help them open up and describe their pain in a better way. The mutual belief that cancer pain is “an enemy” and “a challenge” between ethnic groups may also be greatly utilized to build up plan to support patients to receive better cancer treatment. (Kwok, et.al. 2014,
Part of the introductory assessment of a patient being evaluated for a diagnosis of a substance use disorder
Chapter 14 and the DSM IV defines substance abuse as “a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances” (Ashman, 4th edition 2013, pg. 442).