1.
Identify pediatric populations at risk for poisoning and list 3 agents used for
gastrointestinal decontamination. Describe how nutrition may be affected in a child
who has ingested a poison.
49% in 2011 occurring in children younger than 6 years of age. Activated charcoal -
It can absorb poisons quickly and in large amounts. Gastric lavage - aims to empty
the stomach of toxic substances by the sequential administration and aspiration of
small volumes of fluid via an orogastric tube. Increasing bowel motility Syrup of
ipecac (stimulation of vomit) is contraindicated for routine poison control treatment
for Acetaminophen: Antidote: N-acetylcysteine given orally. (binds the poisonous
forms of acetaminophen that are formed in the liver) Depends on the poison,
sometimes the child can’t have anything to eat because they may be at risk for
aspiration since they may be out of it (stupor). Sometimes the child will be vomiting
also.
2.What psychosocial and developmental interventions should a nurse consider
about home safety when caring for a child who has accidentally ingested toxic
substances? Letting the family be at the bedside of the child at all times. Getting as
much information as possible but try to prevent the atraumatic events from occurring
as much as you can and just being there for the parents and the child and whoever
else is there as well.
Install safety locks/childproof latches on all cabinets to restrict access to children.
Store potential poisons including detergents, medications, and chemical products (like
pesticides and drain cleaners) out of reach and out of sight of children -- inside the house as
well as in the garage or shed. In addition, it's always best to lock them up. Never underestimate
your child's ability to climb.
Store potential poisons in their original containers. Do not transfer them to food containers
like milk jugs, coffee cans, or soda bottles.
Keep food and potential poisons separate; store them in different cabinets. Children can
mistake the identity of products that look alike to them.
Return all products to storage immediately after use. Keep the products and your children in
sight during use.
Safely discard -- into a sealed, outdoor trash receptacle -- all household products and
medications that are old or aren't used regularly.
Never mix products; dangerous fumes could result.
Make sure medications are in child-resistant containers. Vitamins and supplements also
should be out of reach of children. Be especially alert at grandma's house. Older people with
hand arthritis may get medication bottles that are not childproof. They're also more likely to
leave medicine out in the open.
Keep indoor plants out of reach; some may be poisonous.
3.What assessment findings, including your ABC head to toe physical assessment,
might the nurse discover on a pediatric patient who has ingested high levels of
acetaminophen?
1. 0-24 hours
Nausea, Vomiting, Sweating, Pallor
2. 24-72 hours
Patient improves and May have right upper quadrant abdominal pain
3. 72-96 hours
Pain in right upper quadrant, Jaundice, Vomiting, Confusion, Stupor, Coagulation abnormalities,
and Sometimes—renal failure, pancreatitis
4. More than 5 days
Resolution of hepatoxicity or progress to multiple organ failure. May be fatal.
The medication is ordered for 100mg/kg over sixteen hours. The patient weighs 33 lb. How
many milligrams will the nurse administer per dose?___1500__mg (If needed, round to the
nearest tenth.)
2.This dose will arrive from the pharmacy diluted in 225mL of D5W. This is to infuse over
sixteen hours. Calculate the hourly rate of infusion. ___14__mL/hr
3.A provider has ordered D5 0.45 NS w/20 meq KCL/L as maintenance fluid for a patient who
weighs 33 lbs. Using the chart below, what is the volume and rate of maintenance fluid required
in 24 hours? __________ total mL every24 hours at a rate of ______ ml/hr ????
