Addiction, Alcohol Abuse & Eating Disorders — NCLEX-PN Review | Chapter 63: Saunders

Addiction, Alcohol Abuse & Eating Disorders — NCLEX-PN Review | Chapter 63: Saunders

Chapter 63 of Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri delivers a thorough review of eating disorders, addiction, and substance abuse, emphasizing NCLEX-relevant nursing interventions and safe client care. This chapter covers anorexia, bulimia, binge eating, alcohol use disorder, and various substance-related conditions, offering evidence-based strategies for withdrawal management, crisis intervention, and long-term recovery support.

Watch the lecture above for a full NCLEX-oriented review of addiction and eating disorders, then read on for the key nursing considerations and intervention strategies covered in this chapter.

Saunders NCLEX-PN Examination Review book cover

Eating Disorders

  • Anorexia nervosa: extreme weight loss, restrictive eating, distorted body image, bradycardia, hypotension.
  • Bulimia nervosa: binge-purge cycles, dental erosion, electrolyte imbalance, esophageal tears.
  • Binge eating disorder: excessive food intake without purging; linked to obesity, depression.
  • Nursing care: meal supervision, gradual nutritional rehabilitation, electrolyte monitoring, therapeutic communication, body image support.

Alcohol Use Disorder

  • Signs: tolerance, craving, inability to limit intake, neglect of responsibilities.
  • Withdrawal: early signs include tremors, anxiety, insomnia; severe withdrawal delirium includes hallucinations, fever, and disorientation.
  • Complications: Wernicke’s encephalopathy (ataxia, confusion, nystagmus) and Korsakoff’s syndrome (memory loss, confabulation) due to thiamine deficiency.
  • Emergency care: seizure precautions, IV fluids, benzodiazepines, thiamine supplementation.

Medications for Alcohol Dependence

  • Disulfiram: aversion therapy; causes severe reaction with alcohol (flushing, nausea, hypotension).
  • Naltrexone: reduces cravings and pleasure from alcohol.
  • Acamprosate: decreases distress and cravings after abstinence begins.

Substance-Related Disorders

  • CNS depressants: alcohol, barbiturates, benzodiazepines—withdrawal risks include seizures and respiratory depression.
  • CNS stimulants: cocaine, amphetamines—withdrawal causes fatigue, depression, disturbed sleep.
  • Opioids: heroin, morphine, fentanyl—withdrawal symptoms include sweating, pain, diarrhea; naloxone for overdose reversal.
  • Hallucinogens: LSD, PCP—risk of flashbacks, psychosis; provide low-stimulus care.
  • Inhalants: glue, paint, nitrous oxide—cause neurotoxicity, hypoxia, and sudden death.
  • Marijuana: may impair memory and cognition with long-term use; withdrawal is usually mild and supportive.
  • Club drugs: MDMA, ketamine—risk of hyperthermia, dehydration, organ failure.

Codependency & Impaired Healthcare Professionals

  • Codependency involves enabling behaviors in relationships with addicted individuals; addressed through therapy and support groups.
  • Signs of impairment in nurses include frequent absences, medication errors, and changes in job performance; reporting to the State Board and treatment programs is essential.

Support Groups

  • Alcoholics Anonymous (AA): peer-led recovery program.
  • Al-Anon: support for families and friends of those with alcohol use disorder.
  • Halfway houses and group therapy provide structured recovery environments.

NCLEX-Priority Nursing Actions

  • Identify early withdrawal symptoms and intervene promptly.
  • Monitor for complications like seizures, delirium, and electrolyte imbalance.
  • Promote therapeutic communication and crisis intervention skills.

Conclusion

Chapter 63 equips NCLEX-PN candidates with essential knowledge to safely assess, intervene, and support clients with eating disorders, substance abuse, and alcohol dependence. Mastery of this content helps ensure effective, compassionate, and legally sound nursing care for individuals in recovery.

Subscribe to Last Minute Lecture for more NCLEX-focused lectures and nursing study resources.

View the complete Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) playlist here: Complete NCLEX-PN Review Playlist

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