Substance Use Disorder and Chemical Dependency

Clients may exhibit either obvious or hidden signs and symptoms of substance use disorders and/or chemical dependency. Given that these symptoms can pose life-threatening risks, nurses must promptly identify clients with substance use disorders and/or chemical dependency and work collaboratively assist in managing their healthcare.

In this learning experience, learners will acquire knowledge about assessing, caring for, and evaluating clients with substance use disorder and chemical dependence.

3.1 Assessment of Clients for Chemical Dependency and Substance Use Disorder

Clients with chemical dependency are addicted to drugs or alcohol. Those diagnosed with substance use disorder engage in repeated drugs and/or alcohol use, leading to clinical and functional impairments, such as disability, disorders, and difficulties in functioning at work, home, or school (Kaplan Nursing, 2023a). The severity of substance use disorders - mild, moderate, or severe - is determined by the number of diagnostic criteria met by the client. These criteria include evidence of impaired control, social impairment, risky use, and pharmacological criteria (Kaplan Nursing, 2023a).

According to Burke (2023), clients at high risk for substance abuse include those with:

• A genetic predisposition.
• Low self-esteem.
• Low pain tolerance.
• A risk-taking attitude.
• A tendency to self-medicate.
• An unsuccessful life history.
• Vulnerability to peer pressure.
• A psychiatric mental health disorder.

When nurses assess these clients, they may observe signs and symptoms as outlined in Table 1.

Table 1

Some Assessment Findings of Chemical Dependency and Substance Use Disorder

Adapted from Kaplan Nursing. (2023b). NCLEX-RN Content Review Guide: Preparation for the NCLEX-RN Examination (9th ed.). Kaplan Test Prep

3.2 Plan Care of Clients with Chemical Dependency and Substance Use Disorder

When planning care for clients with chemical dependency and substance use disorder, nurses should be well-informed about the definitions of common terms, as outlined in Table 2.

Table 2

Common Terms and Their Definitions

Adapted from Burke, A. (2023). Chemical and Other Dependencies and Substance Abuse Disorder: NCLEX-RN. https://www.registerednursing.org/nclex/chemical-other-dependencies-substance-abuse-disorders/

Clients should receive education about their disorders, potential complications, and their treatment plans (Burke, 2023). Furthermore, nurses must follow the policies and procedures of their healthcare facility when planning client care. It is also essential for nurses to report any abnormal findings and adhere to the follow-up instructions provided by their clients' healthcare providers.

According to Burke (2023), Kaplan Nursing (2023a) and Kaplan Nursing (2023b), the plan of care for clients with chemical dependency and substance use disorder includes:

• Managing presenting symptoms.
• Ensuring airway maintenance, for instance, aiding intubation and suctioning.
• Monitoring for signs of suicidal ideation.
• Assessing and recording the clients' level of consciousness and vital signs.
• Inserting an intravenous line with a large-gauge needle and administering fluids as prescribed.
• Administering medications as ordered and monitoring for both their desired and undesired effects.
• Using restraints as directed by the healthcare provider for client safety.
• Following seizure precautions when necessary.
• Providing appropriate referrals and follow-up care.
• Educating family and friends on how to support the client and encouraging participation in support groups.
• Evaluating the client's response to treatment.

3.3 Evaluation of Clients' Response to Treatment

Nurses should evaluate their clients' response to treatment and adjust their care plans accordingly (Burke, 2023). This involves assessing if the client is:

• Maintaining sobriety.
• Actively participating in individual, family, and/or group therapies.
• Engaging in peer support groups, such as Narcotics Anonymous.
• Complying with prescribed medications and exhibiting therapeutic responses.
• Well-informed about potential relapses and strategies for their prevention.

Additionally, it is important to assess whether any injuries are being appropriately managed and if any nutritional deficiencies are under control, as applicable (Kaplan Nursing, 2023b).

At the end of this learning experience, learners will have acquired knowledge in assessing, caring for, and evaluating clients with substance use disorders and chemical dependency. The main goals are to prepare learners for success in the NCLEX examination and to improve their professional competencies in the workplace.

After reviewing the resources below, it is crucial to identify specific areas that require further improvement and focus on enhancing skills and understanding in these identified areas.

• Burke, A. (2023, September 25). Chemical and Other Dependencies and Substance Abuse Disorder: NCLEX-RN. https://www.registerednursing.org/nclex/chemical-other-dependencies-substance-abuse-disorders/
• Kaplan Nursing. (2023a). Next Generation NCLEX-RN Prep 2023-2024: Practice Test + Proven Strategies (9th ed.).  Kaplan Test Prep.
• Kaplan Nursing. (2023b). NCLEX-RN Content Review Guide: Preparation for the NCLEX-RN Examination (9th ed.). Kaplan Test Prep.

Readings

• Britannica. (n.d.). Chemical Dependency. https://www.britannica.com/science/chemical-dependency

Videos

• Mass General Brigham. (2021, October 13). Substance Use Disorder: Signs, Common Additions, and How to Get Treatment | Mass General Brigham [Video]. YouTube. https://youtu.be/jOJrfjUeSCo