17.2 Plan Nutritional Strategies to Impact Gastrointestinal Wellness
4 min read•june 18, 2024
Nicotine addiction is a complex issue that affects millions worldwide. It's not just about smoking—it's a physical and psychological dependence that can be tough to break. Understanding how nicotine works in the body and its effects is key to tackling this addiction.
Luckily, there are many treatment options available. From nicotine replacement therapies to prescription medications and behavioral support, a comprehensive approach can significantly increase the chances of successfully quitting. As nurses, we play a crucial role in helping patients overcome this challenging addiction.
Nicotine Addiction and Its Effects
Physiological effects of nicotine addiction
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- Nicotine binds to nicotinic acetylcholine receptors (nAChRs) in the brain triggers release of neurotransmitters (dopamine) producing feelings of pleasure and reward
- Chronic nicotine exposure increases number of nAChRs resulting in tolerance and need for higher doses to achieve same effect
- Increases heart rate, blood pressure, and respiratory rate
- Constricts blood vessels reducing blood flow to skin and extremities
- Stimulates release of glucose from liver and increases insulin resistance potentially contributing to development of type 2 diabetes
- Suppresses appetite and increases metabolic rate may lead to weight loss
- Impairs immune system function increasing risk of respiratory infections and delayed wound healing
Signs of nicotine use disorder
- Strong cravings for nicotine
- Difficulty controlling nicotine use despite negative consequences
- Withdrawal symptoms when attempting to quit or reduce nicotine intake:
- Irritability, anxiety, and restlessness
- Difficulty concentrating
- Sleep disturbances
- Increased appetite and weight gain
- Continued use despite physical or psychological problems caused or exacerbated by nicotine
- Neglecting social, occupational, or recreational activities due to nicotine use
- Developing tolerance to nicotine requiring higher doses to achieve desired effect
- Persistent engagement in smoking despite awareness of its harmful effects
Treatment of Nicotine Dependence
Medications for nicotine dependence
- Nicotine replacement therapies (NRTs):
- Nicotine gum
- Nicotine patches
- Nicotine lozenges
- Nicotine inhalers
- Nicotine nasal sprays
- Bupropion (Zyban) antidepressant reduces nicotine cravings and withdrawal symptoms
- Varenicline (Chantix) partial agonist of nAChRs reduces nicotine cravings and rewarding effects of smoking
Mechanism of nicotine replacement therapies
- NRTs deliver controlled doses of nicotine to body reducing withdrawal symptoms and cravings associated with smoking cessation
- Provide lower, slower, and more stable release of nicotine compared to cigarettes allowing user to gradually wean off nicotine
- By reducing cravings and withdrawal symptoms, NRTs increase likelihood of successful smoking cessation
Benefits vs risks of cessation medications
- NRTs:
- Benefits: Reduce cravings and withdrawal symptoms, available over-the-counter (except inhalers and nasal sprays), can be used in combination with other smoking cessation methods
- Risks: Potential side effects such as skin irritation (patches), mouth or throat irritation (gum, lozenges, inhalers), nasal irritation (nasal sprays)
- Bupropion:
- Benefits: Reduces nicotine cravings and withdrawal symptoms, may help prevent weight gain, can be used in combination with NRTs
- Risks: Potential side effects such as dry mouth, insomnia, seizures (rare)
- Varenicline:
- Benefits: Reduces nicotine cravings and rewarding effects of smoking, has higher success rate compared to other medications
- Risks: Potential side effects such as nausea, abnormal dreams, changes in mood or behavior (rare)
Comprehensive Approach to Nicotine Addiction Treatment
Pharmacological interventions
- Medications for nicotine dependence as discussed above
Behavioral therapy
- Cognitive-behavioral therapy to address thought patterns and behaviors associated with smoking
- Motivational interviewing to enhance motivation for quitting
- Stress management techniques to cope with triggers and cravings
Relapse prevention strategies
- Identifying high-risk situations and developing coping strategies
- Building a support network of family, friends, and healthcare professionals
- Implementing lifestyle changes to support a smoke-free life
Nursing Considerations and Patient Education
Nursing considerations for cessation drugs
- Assess patient's nicotine dependence, smoking history, and readiness to quit
- Educate patients on proper use, dosage, and potential side effects of prescribed medication
- Monitor patients for adverse reactions and adjust treatment plan as needed
- Encourage patients to set quit date and provide support throughout cessation process
- Assess and address any underlying mental health conditions that may impact smoking cessation success
- Collaborate with other healthcare professionals (physicians, behavioral therapists) to provide comprehensive care
Patient education for smoking cessation
- Provide information on health benefits of quitting smoking and risks associated with continued nicotine use
- Teach patients about nicotine withdrawal symptoms and coping strategies (deep breathing, exercise, stress management techniques)
- Encourage patients to identify and avoid triggers that may lead to smoking, develop alternative coping mechanisms
- Emphasize importance of adhering to prescribed medication regimen and attending follow-up appointments
- Provide resources for additional support (smoking cessation helplines, support groups, online communities)
- Reinforce message that quitting smoking is a process, setbacks are common but do not indicate failure
- Celebrate milestones and successes throughout cessation process to maintain motivation and commitment to quitting
Key Terms to Review (39)
24-Hour Dietary Recall: A 24-hour dietary recall is a method of dietary assessment where an individual is asked to recall and report all the food and beverages they consumed in the previous 24-hour period. This technique provides a detailed snapshot of an individual's recent dietary intake and is commonly used in nutrition research and clinical practice to evaluate nutritional status and guide dietary interventions.
Absorption: Absorption is the process by which nutrients, minerals, and other substances are taken up from the digestive system and transported into the bloodstream or lymphatic system for distribution throughout the body. It is a critical step in the overall process of digestion and nutrient utilization.
Antacids: Antacids are over-the-counter medications that help neutralize stomach acid, providing relief for conditions like heartburn, acid reflux, and indigestion. They work by counteracting the effects of excess stomach acid, which can irritate the esophagus and stomach lining.
B Vitamins: B vitamins are a group of eight water-soluble vitamins that play crucial roles in various metabolic processes within the body, particularly in supporting neurological and gastrointestinal wellness. These essential nutrients are vital for the proper functioning of the nervous system, energy production, and the maintenance of overall health.
Bifidobacterium bifidum: Bifidobacterium bifidum is a species of probiotic bacteria that is commonly found in the human gastrointestinal tract, particularly the large intestine. It is considered a beneficial microorganism that plays a crucial role in maintaining gastrointestinal wellness and overall health.
Bloating: Bloating refers to a feeling of fullness, tightness, or discomfort in the abdominal area, often accompanied by increased gas or distension. It is a common gastrointestinal issue that can impact overall digestive wellness and comfort.
Celiac Disease: Celiac disease is an autoimmune disorder in which the immune system mistakenly attacks the small intestine when gluten, a protein found in wheat, barley, and rye, is consumed. This leads to inflammation, damage to the intestinal lining, and impaired nutrient absorption. Celiac disease is closely tied to various aspects of nutrition and health, including minerals, supplements, digestive function, gut health, hematological wellness, and gastrointestinal conditions.
Colon: The colon, also known as the large intestine, is the final section of the digestive tract. It plays a crucial role in the digestion, absorption, and elimination of waste products from the body, making it an integral component of the gastrointestinal system.
Constipation: Constipation is a condition characterized by infrequent or difficult bowel movements, often accompanied by hardened stool and discomfort. It is a common gastrointestinal issue that can have significant impacts on overall health and wellness when not properly addressed through nutritional strategies.
Crohn's Disease: Crohn's disease is a chronic, inflammatory bowel disease that can affect any part of the gastrointestinal tract, most commonly the end of the small intestine (the ileum) and the beginning of the colon. It is characterized by periods of flare-ups and remission, and can significantly impact the body's ability to digest and absorb nutrients, leading to various nutritional and digestive complications.
Digestive Enzymes: Digestive enzymes are specialized proteins produced by the body that catalyze the breakdown of food into smaller, absorbable molecules. They play a crucial role in the digestive system's ability to effectively process and utilize the nutrients from the foods we consume.
Dysbiosis: Dysbiosis refers to an imbalance or disruption in the composition and diversity of the gut microbiome, the trillions of microorganisms that reside in the human digestive tract. This imbalance can have significant impacts on various aspects of health, including digestive function, immune response, and overall wellbeing.
Elimination Diet: An elimination diet is a methodical process of temporarily removing certain foods or food groups from the diet to identify potential food sensitivities or allergies that may be contributing to gastrointestinal symptoms or other health issues. This approach is commonly used to assess and manage gastrointestinal wellness.
Enteral Nutrition: Enteral nutrition refers to the delivery of nutrients directly into the gastrointestinal tract, typically through a feeding tube. It is a method of providing nourishment to individuals who are unable to meet their nutritional needs through oral intake alone.
Fiber: Fiber refers to the indigestible parts of plant-based foods that pass through the human digestive system without being broken down. It plays a crucial role in maintaining gut health, managing chronic conditions, and promoting overall wellness.
FODMAP Diet: The FODMAP diet is a nutritional approach that focuses on the management of gastrointestinal symptoms by limiting the intake of specific types of carbohydrates known as FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols). This diet is commonly used to help individuals with conditions like irritable bowel syndrome (IBS) and other functional gastrointestinal disorders manage their symptoms.
Food Allergies and Intolerances: Food allergies and intolerances are adverse reactions to the consumption of certain foods, which can have significant impacts on gastrointestinal wellness. These conditions involve the immune system's response to specific food proteins or the body's inability to properly digest and metabolize certain food components.
Food Frequency Questionnaire: A food frequency questionnaire (FFQ) is a tool used in nutrition research and population health assessments to evaluate an individual's or a group's usual dietary intake over a specified period of time. It is a comprehensive survey that asks about the frequency of consumption of various food items, allowing researchers to estimate nutrient intake and dietary patterns.
Glutamine: Glutamine is a non-essential amino acid that plays a crucial role in various physiological processes, particularly in relation to gastrointestinal wellness and chronic gastrointestinal illnesses. As a key nutrient, glutamine is essential for maintaining the integrity and function of the gastrointestinal tract, making it an important consideration in nutritional strategies to impact and evaluate gastrointestinal wellness.
Gut-Brain Axis: The gut-brain axis refers to the bidirectional communication between the gastrointestinal tract and the central nervous system. This complex network involves the interaction between the gut microbiome, the enteric nervous system, and the brain, allowing for the integration of signals that influence various physiological and behavioral processes.
Inflammatory Bowel Disease: Inflammatory bowel disease (IBD) is a group of chronic, relapsing inflammatory conditions that primarily affect the gastrointestinal tract. The two main types of IBD are Crohn's disease and ulcerative colitis. IBD can significantly impact an individual's nutritional status, digestive function, and overall well-being, making it an important consideration across various nursing and nutrition-related topics.
Insoluble Fiber: Insoluble fiber is a type of dietary fiber that cannot be dissolved in water. It passes through the gastrointestinal tract largely intact, adding bulk to stool and promoting regular bowel movements. This fiber type is an essential component of a healthy diet, with implications across carbohydrate metabolism, gastrointestinal wellness, and overall nutritional strategies.
Iron: Iron is a crucial mineral essential for producing hemoglobin, which transports oxygen in the blood. It also plays a vital role in various metabolic processes and maintaining healthy cells, skin, hair, and nails.
Irritable Bowel Syndrome: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by recurrent abdominal pain, discomfort, and altered bowel habits, such as diarrhea, constipation, or a combination of both. IBS is a complex condition that can significantly impact an individual's quality of life and is an important consideration in the promotion of gut health, the assessment and analysis of the impact of nutrition on the gastrointestinal system, the planning and evaluation of nutritional strategies to improve gastrointestinal wellness, and the impact of nutrition on gastrointestinal wellness across the lifespan.
Lactobacillus acidophilus: Lactobacillus acidophilus is a beneficial probiotic bacteria that naturally resides in the human gastrointestinal tract. It is known for its ability to promote digestive health and support the overall balance of the gut microbiome.
Leaky Gut Syndrome: Leaky gut syndrome refers to a condition where the intestinal lining becomes more permeable, allowing undigested food particles, toxins, and bacteria to pass through the gut barrier and enter the bloodstream. This can trigger an inflammatory response and contribute to various health issues.
Malabsorption: Malabsorption is the impaired absorption of nutrients from the gastrointestinal tract. It can lead to deficiencies in essential vitamins and minerals, impacting overall health and wellness.
Microbial growth: Microbial growth is the increase in the number of microorganisms in a given environment. In the human gut, this can influence digestion and overall gastrointestinal health.
Microbiota: Microbiota refers to the diverse community of microorganisms, including bacteria, archaea, fungi, and viruses, that reside within the human gastrointestinal tract. These microbes play a crucial role in maintaining gastrointestinal wellness and overall health.
Mindful Eating: Mindful eating is the practice of being fully present and attentive while consuming food, with a focus on the sensory experience, internal cues, and the overall relationship with food. It is a holistic approach to nourishment that emphasizes the importance of conscious awareness in the context of gastrointestinal wellness.
Parenteral Nutrition: Parenteral nutrition refers to the intravenous administration of nutrients, including carbohydrates, proteins, lipids, vitamins, and minerals, to individuals who are unable to meet their nutritional needs through oral or enteral (tube) feeding. This method of nutrition delivery bypasses the gastrointestinal tract, providing essential nutrients directly into the bloodstream to support various aspects of health, including hematologic, pulmonary, and gastrointestinal wellness.
Peristalsis: Peristalsis refers to the coordinated, wave-like muscular contractions that propel food and other contents through the digestive tract. This involuntary movement is essential for the proper functioning of the gastrointestinal system, facilitating the movement of food, liquids, and waste products from the esophagus to the anus.
Prebiotic Foods: Prebiotic foods are a type of dietary fiber that feed the beneficial bacteria, known as probiotics, in the gut. They promote the growth and activity of these helpful microorganisms, which in turn support overall gastrointestinal wellness.
Probiotics: Probiotics are live microorganisms, primarily bacteria, that when consumed in adequate amounts, provide health benefits to the host. They are often referred to as the 'good' or 'friendly' bacteria that reside in the human gastrointestinal tract and play a crucial role in maintaining gut health and overall well-being.
Small Intestine: The small intestine is a vital part of the human digestive system, responsible for the absorption of nutrients from the food we consume. It is a long, coiled tube that connects the stomach to the large intestine, playing a crucial role in the physical assessment of digestive organs, the function of digestive organs, the assessment and analysis of the impact of nutrition on the gastrointestinal system, the planning of nutritional strategies to impact gastrointestinal wellness, and the evaluation of nutritional strategies to impact gastrointestinal wellness.
Soluble Fiber: Soluble fiber is a type of dietary fiber that dissolves in water, forming a gel-like substance in the digestive tract. This fiber plays a crucial role in carbohydrate metabolism, gastrointestinal health, and the implementation of nutritional strategies to promote overall wellness.
Vitamin A: Vitamin A is a fat-soluble vitamin that plays a crucial role in various physiological processes, including vision, immune function, cell growth and differentiation, and the maintenance of healthy skin and mucous membranes. It is an essential nutrient that must be obtained through dietary sources or supplementation.
Vitamin C: Vitamin C, also known as ascorbic acid, is a water-soluble vitamin essential for the growth and repair of tissues in all parts of the body. It acts as an antioxidant and plays a crucial role in collagen synthesis, immune function, and absorption of iron from plant-based foods.
Vitamin D: Vitamin D is a fat-soluble vitamin that plays a crucial role in maintaining overall health and wellness. It is often referred to as the 'sunshine vitamin' because the body can synthesize it when the skin is exposed to sunlight. Vitamin D is essential for the regulation of calcium and phosphorus levels in the body, supporting strong bones and teeth, and it also has important functions in various other physiological processes.