A nurse in an emergency department is caring for a child who weighs 18 kg (39.7 lb) and ingested six 500 mg acetaminophen tablets 4 hr ago. Which of the following actions should the nurse take?
Perform gastric lavage with activated charcoal.
Begin hemodialysis within the next 24 hr.
Prepare to give oral N-acetylcysteine.
Send the child home on increased fluid intake.
The Correct Answer is C
A. Perform gastric lavage with activated charcoal. Activated charcoal is most effective if given within 1 hour of ingestion. Since the ingestion occurred 4 hours ago, activated charcoal would not be beneficial.
B. Begin hemodialysis within the next 24 hr. Hemodialysis is only used in severe cases of acetaminophen toxicity with liver failure, which is not indicated at this stage.
C. Prepare to give oral N-acetylcysteine. N-acetylcysteine (NAC) is the antidote for acetaminophen overdose and should be administered as soon as possible within 8 to 10 hours after ingestion to prevent liver damage.
D. Send the child home on increased fluid intake. Acetaminophen overdose can cause severe liver toxicity, so treatment in a medical setting is required, not just increased fluids at home.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "Keep the car seat in a rear-facing position until your infant is 2 years old." The American Academy of Pediatrics (AAP) recommends keeping infants in a rear-facing car seat until at least 2 years of age or until they reach the height and weight limits specified by the car seat manufacturer for optimal safety.
B. "Fasten the harness over your infant's winter coat." Bulky clothing (such as winter coats) should not be worn under the harness because it can create excess space, reducing the effectiveness of the restraint and increasing injury risk. Instead, the infant should be dressed in thin layers, and a blanket can be placed over the secured harness if warmth is needed.
C. "Ensure the airbag is activated if the car seat is in the front passenger seat." Infants should never be placed in the front passenger seat if the car has an active airbag. Airbags can cause severe injury or death if deployed while a rear-facing car seat is in place. The safest position is always in the back seat.
D. "Pad the backrest of the car seat with a thick blanket before securing your infant." Additional padding should not be used, as it can interfere with the proper fit of the harness and compromise safety. Car seats are designed to provide adequate support and protection without extra cushioning.
Correct Answer is C
Explanation
A. Redcurrant, jelly-like stools. This is more characteristic of intussusception, a different gastrointestinal condition, rather than celiac disease.
B. Increased hemoglobin level. Celiac disease often leads to malabsorption, which can cause iron-deficiency anemia, leading to a decreased hemoglobin level, not an increased one.
C. Pale, oily stools. Children with celiac disease have difficulty absorbing fats, leading to steatorrhea (pale, oily stools). This is a classic sign of malabsorption in celiac disease.
D. Hematemesis. Hematemesis (vomiting blood) is not a typical sign of celiac disease. It may indicate a different GI issue, such as gastric bleeding.
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