| Question | Answer |
| 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) |
