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90% of poisoning occurs at__?
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At which age has the highest rate of Poisoning cases?
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Pediatric Poisoning

QuestionAnswer
90% of poisoning occurs at__? HOME
At which age has the highest rate of Poisoning cases? 6 yrs of age
At which age is MOST COMMON in poisoning? ages 2-3 yo
4th Leading cause of death in Toddlers and Preschoolers is __? Poison ingestion
What is a PREVENTABLE mechanism to Poison control? NEVER tell a child Medicine is Candy
WHen a child comes in contact with poison ingestion what is the FIRST INtervention? CALL Poison COntrol Center FIRST
ASSESSMENT: Do you treat poison first or the child first? CHILD first
How do you assess a victim? ABC.. Airway (Life head to clear airway), Breathing (check to see rise and far of chest), Circulation (check pulse); Vital signs breath odor
What is your Nursing Plan Intervention? -identify poisonous agent quickly -assess ABC -instruct parnet to bring stool emesis -determine child age/weight -tell parent not to induce any emesis(Ipecac)
What is you Emergency Management/Treatment to Poisoned child? -Gastric lavage -Activated Charcoal -Cathartic agent (magnesium citrate, Sorbitol)
What is Gastric Lavage? Stomach pumping; irrigate stomach (rarely used bc it can cause complications/aspirate)
What are conditions appropriate for a Gastric Lavage? 1 hr of ingesting TOxin
What is the best method to deactivate Poison in the ER? Give Activated Charcoal:PO or via NGT
What is the dosage amount of administering activated Charcoal? 1g/kg
What are the reactions to activated Charcoal? Odorless, tasteless, fine black powder -Excreted via bowel over 3 days: stools appear BLACK
What can Activated Charcoal be mixed with? What does it resemble after mixing ingredients? H20, Saline cathartic;Looks like Black Blood; Muddy look. BEST MIXED WITH DIET SODA served with a straw in OPAQUE cup/glass or disposable coffee cup with lid
Why is Activated Charcoal mixed with Diet soda? Bc sugar found in (ice-cream, candy) takes up binding sites. Kicks poison off binding site
What are some complication to activated charcoal complications? -Aspiration, Pneumothorax, Constipation, Intestinal Obstruction (multiple doses)
When inserting NG Tube; what is the most RELIABLE indicator of correct placement of tube? -Checking pH -Scope in abdominal wall
What confirms correct placement of NG tube? -X-ray
NURSING IMPLICATION: NG tube is required when pt is ___. Uncooperative
What are some prevention of Recurrence? -Educate and Prepare parents- Assess all possible contributing factors -Do not refer to medicine as candy
AST? Serum Aspartate Aminotransaminase
ALT? Serum Alanine Aminotransaminase
What are the levels Toxicity in children of Acetaminophen (Tylenol)? More than 150 mcg/kg or double the recommended maximum therapeutic dose of 90 mg/kg
Which organ does Acetaminophen primarily effect in the body? Liver; Hepatic movement
What 2 enzymes elevate in the hepatic portal system during Acetaminophen toxicity? AST (Serum Aspartate Aminotransaminase); ALT (Serum Alanine Aminotransaminase)
What medication is the most common accidental poison to children as result of acute ingestion? Tylenol; acetaminophen
LFT Liver Function Test; Hepatic panal
TYLENOL: What happens in Stage 1 post ingestion? 2-4 hrs; Nausea, Anorexia, Diaphoresis (sweating), palor
TYLENOL: What happens in Stage 2 latent period
TYLENOL: what ahppens in stage 3 Hepatic involvement? -jaundice, pain in Right upper Quadrant (RUQ), Abd. tenderness, Stuporous (state of numbness), confusion
TYLENOL: What happens in stage 4/Recovery stage? -Look at PT/PTT (Coagulation test; takes 7 days as patients can recover
What is the treatment for Acetaminophen? -Parents call Poison control center (PCC) -ER Tx: N-Acetylcysteine (Mucomyst)
What does N-Acetylcysteine (Mucomyst) do to body? Prevents Hepatic Toxicity by binding with the breakdown product of acetaminophen to prevent drug from binding to liver cells
How much N-Acetylcysteine (Mucomyst) do you administer? -Given in PO as loading dose: 140 mg/kg then 17 additional doses (maintenance) of 70 mg/kg q4h
What do you dilute N-Acetylcysteine (Mucomyst) into for taste? Fruit Juice and Cola
What does N-Acetylcysteine smell like? Rotten eggs
What are the nursing measures for a hospitalized child after administering Mucomyst? -continue to observe -screen for LAB: LFT, Tylenol level, PT/PTT, CBC, BUN/Creat, BMP (Basic Metabolic Level of Potassium)
BUN/CREAT? BUN= serum; nething can increase BUN CREATINE= rate of which kidneys function; Glumerula functions)
Acetaminophen:What are the therapeutic levels? 10-30mcg/ml
Acetaminophen:What are the toxic levels? more than 200 mcg/ml
ASPIRIN: What is the dosage amount to have Acute ingestion to be poisoned? Acute: severe toxicity with 300-500 mg/kg days
ASPIRIN: What is the dosage amount to have Chronic ingestion to be poisoned? Chronic: more than 100mg/kg/day for 2 or more
ASPRIN: What would you assess if pt is poisoned? -GI: N/V, thirst(dehydration) -CNS: hypernea (deep n rapid breathing) confusion, tinnitus(ringing or buzzing in ears, convulsions, coma, RF (saliczon: continuous buzzing in ears), circulatory collapse
ASPRIN: What would you assess if pt is poisoned? -Renal: oliguria -Hematopoietic: Bleeding tendencies -Metabolic: Resp. alkalosis as a result of hyperventilation, METABOLIC ACIDOSIS (body filled with acid) Hypokalemia
Hypokalemia? Low K+ levles; NEver give K+ if pt is not urinated thoroughly
ASPRIN: TREATMENT -activated charcoal ASAP -NaHC03 IV to correct METABOLIC ACIDOSIS -Urinary alkalinization to enhance elimination -External cooling
ASPRIN: TREATMENT -urinary alkalinization to enhance elimination -external cooling -02 & ventilation -Vit K for bleeding -Anticoagulants -HEMODIALYSIS: SEVER CASES (Filter out poison)
Created by: usmell
 

 



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