A patient has been abusing an antianxiety medication. Which assessment by the nurse would confirm this is psychological dependence instead of physical dependence?
1. The patient's history reveals the long-term use of high doses of an antianxiety medication.
2. The patient describes the "need" to use the antianxiety medication despite not feeling anxious.
3. The patient describes feeling nauseous with abdominal cramping.
4. The patient tells you her family has "disowned" her because of her need for the antianxiety medication.
5. The patient complains she has not slept in days, feels anxious, and is tired.
1,2,4
Rationale 1: Psychological dependence usually requires the use of relatively high doses of antianxiety medication over a prolonged period of time.
Rationale 2: Psychological dependence is the "need" or desire to continue taking a drug when there is a lack of physical symptoms. In this case, the patient does not feel anxious but still has the desire to take the antianxiety medication.
Rationale 3: Physical dependence produces physical signs of discomfort when the agent is discontinued. This is not true of psychological dependence.
Rationale 4: To continue the use of the antianxiety drug at the risk of jeopardizing relationships is indicative of psychological dependence.
Rationale 5: Physical dependence produces physical signs of discomfort when the agent is discontinued. This is not true of psychological dependence.
Global Rationale: Psychological dependence usually requires the use of relatively high doses of antianxiety medication over a prolonged period of time. Psychological dependence is the "need" or desire to continue taking a drug when there is a lack of physical symptoms. In this case, the patient does not feel anxious but still has the desire to take the antianxiety medication. To continue the use of the antianxiety drug at the risk of jeopardizing relationships is indicative of psychological dependence. Physical dependence produces physical signs of discomfort when the agent is discontinued. This is not true of psychological dependence. Physical dependence produces physical signs of discomfort when the agent is discontinued. This is not true of psychological dependence.
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