What is a clinical manifestation of acetaminophen poisoning?

Correct Answer: B

Rationale: In the context of acetaminophen poisoning, the correct clinical manifestation is hepatic involvement (Answer B). Acetaminophen toxicity primarily affects the liver, leading to hepatic necrosis and liver failure. This is a crucial clinical sign to recognize as prompt treatment is essential to prevent severe complications and potential death. Option A (Hyperpyrexia) is incorrect because acetaminophen poisoning typically does not cause high fever. Option C (Severe burning pain in stomach) is also incorrect as acetaminophen toxicity may cause abdominal pain but not specifically described as severe burning pain. Option D (Drooling and inability to clear secretions) is unrelated to acetaminophen poisoning and may be seen in other conditions affecting the respiratory and salivary systems. In an educational context, understanding the clinical manifestations of acetaminophen poisoning is vital for nurses caring for children. Recognizing these signs early can prompt timely interventions and prevent further harm. Nurses should also be aware of the importance of accurate medication dosing to prevent accidental acetaminophen toxicity in pediatric patients.

Correct Answer: D

Rationale: The correct action for the nurse to take next after initiating CPR for a child suspected of ingesting poison is to call poison control (Option D). This is the most crucial step as poison control experts are specifically trained to provide immediate and accurate guidance on managing poison exposures. In cases of poisoning, time is of the essence, and getting expert advice promptly can save the child's life. Option A, emptying the mouth of pills, plants, or other material, is incorrect because it can potentially lead to further harm if done incorrectly. It is crucial to avoid inducing vomiting in cases of poisoning without proper guidance. Option B, questioning the victim and witness, is not the priority at this moment. The immediate focus should be on ensuring the child's safety and obtaining expert advice. Option C, placing the child in a side-lying position, is a general first aid measure for an unconscious child but is not the next step to take after initiating CPR for a suspected poisoning. In an educational context, it is vital for nurses to be well-versed in the correct steps to take in emergencies such as poisoning. Understanding the importance of seeking expert advice from poison control centers can help nurses provide efficient and effective care to pediatric patients in critical situations.

Correct Answer: D

Rationale: In the case of acetaminophen poisoning, the correct antidote that the nurse should anticipate being prescribed is N-acetylcysteine (Mucomyst). N-acetylcysteine is the antidote for acetaminophen overdose as it helps replenish glutathione levels in the liver, which aids in neutralizing the toxic metabolites of acetaminophen. Option A) Carnitine (Carnitor) is used in the treatment of certain metabolic disorders and is not indicated for acetaminophen poisoning. Option B) Fomepizole (Antizol) is used in the treatment of ethylene glycol or methanol poisoning, not acetaminophen poisoning. Option C) Deferoxamine (Desferal) is used in iron poisoning, not acetaminophen poisoning. Educationally, it is crucial for nurses to understand the specific antidotes for different types of poisonings to provide timely and effective care to patients. Knowing the correct antidote for acetaminophen poisoning is essential as it can prevent serious liver damage and even save a patient's life. Nurses should be familiar with the indications, contraindications, and administration of antidotes to ensure safe and competent care for patients in emergency situations.

Correct Answer: D

Rationale: In the case of a child with acetylsalicylic acid (aspirin) poisoning being admitted to the emergency department, the early clinical manifestation that the nurse would expect to assess is hyperventilation. This is because aspirin poisoning can lead to respiratory alkalosis, causing the child to hyperventilate as a compensatory mechanism to try to normalize the blood pH. Option A) Hematemesis, vomiting blood, is not typically an early clinical manifestation of aspirin poisoning. It may occur later in severe cases due to gastrointestinal bleeding. Option B) Hematochezia, the passage of fresh blood through the rectum, is also not an early sign of aspirin poisoning. It may occur in advanced stages if there is gastrointestinal bleeding. Option C) Hyperglycemia is not a typical early clinical manifestation of aspirin poisoning. Aspirin poisoning is more likely to cause metabolic acidosis rather than hyperglycemia. Educational Context: Understanding the clinical manifestations of aspirin poisoning is crucial for nurses caring for children. Early identification of symptoms like hyperventilation can prompt swift interventions and prevent further complications. Aspirin poisoning can be serious, so prompt recognition and management are essential for improving patient outcomes.

Correct Answer: C

Rationale: Activated charcoal is commonly used in cases of poisoning to prevent absorption of toxins in the gastrointestinal tract by binding to them. In the scenario of acetaminophen poisoning in a preschool child, potential complications from activated charcoal administration include diarrhea, vomiting, and risk of aspiration. Option A: Diarrhea is a common side effect of activated charcoal due to its cathartic effect. It helps eliminate toxins from the body rapidly. Option B: Vomiting can occur as activated charcoal may induce nausea and vomiting, which could lead to aspiration of stomach contents. Option D: Intestinal obstruction is a rare but serious complication, especially in patients with a compromised gastrointestinal tract or if a large amount of charcoal is given. It can cause blockages in the intestines. The correct answer is C because all the options are potential complications of activated charcoal administration. It is crucial for nurses to monitor for these side effects to prevent further harm to the child. Understanding these complications is vital for pediatric nurses to provide safe and effective care in cases of poisoning.