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 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.
Correct Answer is B
Explanation
A. "Apply scented baby powder to absorb residual moisture." Scented products can irritate the vaginal area and worsen symptoms of vulvovaginitis. Instead, keeping the area dry and clean is recommended.
B. "Apply a warm, moist compress three times per day." Warm compresses help soothe irritation and reduce inflammation associated with vulvovaginitis.
C. "Wear a feminine deodorant pad for vaginal drainage." Deodorant pads contain chemicals that can further irritate the area. Instead, using unscented pads or breathable cotton underwear is recommended.
D. "Wear nylon underwear at night." Nylon traps moisture and heat, which creates an environment for bacterial and fungal growth. Instead, wearing loose-fitting cotton underwear or sleeping without underwear is recommended to promote airflow and prevent irritation.
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