CHAPTER 4 Substance Abuse^77
into the brain), convulsions, coma, and death. Patients who have used PCP should
be closely monitored.
Inhalants
Inhalants are not drugs. They are volatile hydrocarbons and aerosols that are
used to dispense a variety of chemical products that create a euphoric effect
when inhaled. These products include airplane glue, paint thinner, typewriter
correction fluid, lighter fluid, nitrous oxide, xylene, toluene, and include over
1000 household and commercial products. Treatment of abuse of inhalants uses
a symptomatic approach rather than a pharmacological approach because there
are no specific antidotes to these products. When inhaled, the intoxication can
last a few minutes or several hours. If used repeatedly, the individual can lose
consciousness; high concentrations can cause heart failure or death. Some of the
products can replace oxygen in the body and the individual can suffocate. Each
of these side effects needs to be treated separately. The permanent health effects
caused by the use of these inhalants can include hearing loss, peripheral neu-
ropathies (numbness, tingling) or spasms of arms and legs, CNS or brain dam-
age and bone marrow damage, that results in blood problems. Kidney and liver
damage can also occur.
Nursing Assessment
Patients who abuse drugs require a careful and complete assessment which
includes vital signs (temperature, blood pressure, heart rate, and respiratory rate).
Pupil size is inspected and the skin is examined for needle marks and abscesses.
The patient’s nutrition, elimination, and sleep patterns are noted, too. Determine
if the patient has a past medical history of drug use, drug abuse, and related drug
illnesses such as HIV, cellulitis, endocarditis, and pneumonia or other respira-
tory problems.
The following are commonly used nursing diagnoses for drug abuse patients:
- Knowledge deficit related to denial of problem
- Ineffective individual coping related to lack of support system
- Risk for violence to oneself or others related to drug use
- Altered health maintenance related to drug dependency
- Ineffective management of therapeutic regimen