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.
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Related Questions
Correct Answer is D
Explanation
A. "Apply firm pressure to the wound base while removing the gauze dressing." Applying firm pressure can cause pain and damage the wound bed, delaying healing and increasing the risk of bleeding.
B. "Irrigate the wound with half-strength hydrogen peroxide while removing the gauze dressing." Hydrogen peroxide can damage healthy tissue and delay wound healing. It is not recommended for routine wound care.
C. "Continue to remove the gauze dressing by pulling it parallel to the skin." Removing a dry gauze dressing without moistening it can cause trauma to the wound bed, increasing pain and impeding healing.
D. "Saturate the gauze dressing with sterile saline solution prior to removing it." Moistening the dressing with sterile saline reduces trauma to the wound, prevents tissue damage, and minimizes pain. This method is preferred for atraumatic dressing removal.
Correct Answer is B
Explanation
A. "The obstruction will be treated with a medication called indomethacin." Indomethacin is used to close a patent ductus arteriosus (PDA), not to treat coarctation of the aorta. Instead, prostaglandins may be used temporarily to keep the ductus arteriosus open and improve blood flow until surgery.
B. "Surgical repair is the recommended treatment for infants younger than 6 months old." Coarctation of the aorta does not resolve on its own and requires surgical intervention, typically within the first few months of life. Options include resection with end-to-end anastomosis or balloon angioplasty in some cases.
C. "The cardiologist will monitor your infant closely until they are able to receive treatment with a heart transplant." Heart transplant is not the standard treatment for coarctation of the aorta; surgery or catheter-based intervention is the preferred approach.
D. "Most cases resolve spontaneously without treatment by 12 months of age." Coarctation of the aorta does not resolve on its own. If left untreated, it can lead to heart failure, hypertension, and other complications.
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