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Unfolding Case Study

b. This is important to assess in case the client is prescribed buprenorphine or naltrexone to avoid withdrawal symptoms.
d. Diarrhea is a common symptom of opioid withdrawal and can occur if clients continue to use opioids while taking the opioid antagonist naltrexone.
a. This is the only medication of the four listed that is indicated for smoking cessation.
b. The client’s quit date should be one week after starting varenicline, to reduce withdrawal symptoms and increase chances for successful cessation.

Review Questions

c. This client had a sudden discontinuation of their oxycodone, leading to typical opioid withdrawal effects.
d. This client is experiencing the behavioral aspects of discontinuation of a substance, leading to intense cravings.
b. The Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) uses a symptoms-based approach to manage the symptoms of alcohol withdrawal as they occur.
a. This client is experiencing the triad of opioid overdose symptoms (respiratory depression, CNS depression, and miosis). This client requires quick reversal of these effects, so naloxone should be administered.
c. The naloxone in this drug makes it so that if it is injected instead of being used orally, it will prevent the buprenorphine from causing as much euphoria as it would by itself.
a. Because of the short-acting nature of naloxone, it is imperative to call emergency services after naloxone administration to get definitive care prior to the client re-sedating.
b. Facial flushing is one of the most characteristic reactions seen in clients consuming alcohol while using disulfiram.
d. Seizures are one of the most severe and potentially life-threatening effects that can be seen with alcohol withdrawal.
c. This is an important counseling point to avoid having the client receive excessive doses of nicotine, leading to toxicity.
a. Because bupropion is primarily used as an antidepressant and can reduce cravings during smoking cessation, it is an ideal medication to treat both conditions.

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