Ch. 42: Pediatric Emergencies-Poisoning Flashcards Preview

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Flashcards in Ch. 42: Pediatric Emergencies-Poisoning Deck (32):
1

What age is a risk factor for poisoning?

Younger than 6

2

What are examples of some other risk factors for poisoning?

-Improperly stored meds, household chemicals, and hazardous substances
-Exposure to plants, cosmetics, and heavy metals (all are potential sources of toxic substances)
-LEAD ingestion from lead-based paint, soil contamination

3

What are the symptoms of acetaminophen (tylenol) poisoning 2-4 hours after ingestion?

N/V
Sweating
Pallor

4

What are the symptoms of acetaminophen (tylenol) poisoning 24-36 hours after ingestion?

Improvement in the child's condition

5

What are the symptoms of acetaminophen (tylenol) poisoning 36 hours-7 days or longer after ingestion?

This is the hepatic stage!!!

-Pain in RUQ
-Confusion
-Stupor
-Jaundice
-Coagulation disturbances

6

What is the final stage to acetaminophen poisoning (like was never treated)?

Death or gradual recovery

7

What are acute poisoning signs for acetylsalicylic acid (aspirin)?

N.V
Disorientation
Diaphoresis
Tachypnea
Tinnitus
Oliguria
Lightheadedness
Seizures

8

What are chronic poisoning signs for acetylsalicylic acid (aspirin)?

Subtle version of acute manifestations
Bleeding tendencies
Dehydration
Seizures (more severe though compared to acute poisoning seizures)

9

What are the 4 poisoning periods for a child who got poisoned with supplemental iron?

1. Initial period
2. Latency period
3. Systemic toxicity period
4. Hepatic injury period

10

When and what happens in the initial period of iron poisoning?

Initial: 30 min-6 hr after ingestion

Vomiting
Hematemesis
Diarrhea
Gastric pain
Bloody stool

11

When and what happens during the latency period of iron poisoning?

Latency: 2-12 hours after ingestion

Improvement in condition

12

When and what happens during the systemic toxicity period of iron poisoning?

Systemic toxicity: 4-24 hours after ingestion

METABOLIC ACIDOSIS
HYPERglycemia
Bleeding
Fever
Shock
Possible death

13

When and what happens in the hepatic injury of iron poisoning?

Hepatic injury: 48-96 hours after ingestion

Seizures or coma

14

What are hydrocarbons?

Gasoline, kerosene, lighter fluid, paint thinner, turpentine

15

What are some objective data signs of ingesting hydrocarbons?

Gagging, choking, coughing, N.V
Lethargy, weakness, tachypnea, cyanosis, grunting, retractions

16

What are corrosives?

Household cleaners, batteries, denture cleaners, bleach

17

What are some objective data signs of ingesting corrosives?

-Pain in burning in mouth, throat, and stomach
-Edematous lops, tongue, and pharynx with WHITE mucous
-VIOLENTLY vomiting with hemoptysis
-Drooling, anxiety, shock

18

What are low-dose exposure signs of lead poisoning?

Easily distracted
Impulsive
HYPERactive
Hearing impairment
Mild intellectual difficulty

19

What are high-dose exposure signs of lead poisoning?

Cognitive delays varying in severity
Blindness
Paralysis
Coma, seizures, death

20

What are other manifestations seen with lead poisoning?

KIDNEY impairment
Impaired CALCIUM function
Anemia

21

What is the intervention for acetaminophen poison?

N-acetylcysteine (Mucomyst) --given PO

22

What are some interventions for acetylsalicylic acid (aspirin) poisoning?

Activated charcoal
Gastric lavage
Sodium bicarbonate
Oxygen and ventilation
Vit. K
Hemodialysis (for severe cases)

23

What are some interventions for supplemental iron poisoning?

Emesis or lavage
Chelation therapy using deferoxamine mesylate

24

Is it okay to induce vomiting if the child is in for ingesting a hydrocarbon?

NO DO NOT INDUCE VOMITING

25

Since we can't induce vomiting for hydrocarbon poisoning, what do we do?

Intubation with cuffed endotracheal tube is done prior to decontamination--treatment of chemical pneumonia

26

What are the nursing interventions for treatment of a child who ingested a corrosive?

Airway maintenance
NPO
No attempt to neutralize the acid
Don't induce vomiting
Analgesics for pain

27

What is the intervention used for lead poisoning?

Chelation therapy using calcium EDTA

28

What 2 poisons do we NOT induce vomiting?

Hydrocarbon and corrosive poisoning

29

What are some poison prevention methods?

-Keep toxic things out of reach
-Lock cabinets that have potentially harmful substances
-Don't take meds in front of kids!, get rid of unused meds!, don't tell a child their medicine is candy!!!
-Use NON-mercury thermometers
-Eliminate lead-based paint in environment
-Hand hygiene prior to eating
-DO NOT store food in lead asked containers

30

Who do we do routine screenings for lead levels--like what age?

1, 2, and 3 years of age this is done

31

A nurse is teaching a patient about acetaminophen poisoning. Which of the following statements by the nurse should be included in the teaching?
A. "Nausea begins 24 hours after ingestion"
B. "Pallor can appear as early as 2 hours after ingestion"
C. "Jaundice will appear in 12 hours if your child is toxic"
D. "Children can have 4grams of acetaminophen a day"

B

A. Nausea begins 2-4 hours after ingestion
B. CORRECT--Pallor starts 2-4 hours after ingestion
C. Jaundice appears 36h-7d later
D. Max dose for children in
-2-5 years= 720mg/d
-6-12= 2.6 g/d

32

A nurse is caring for a child who has swallowed paint thinner. The child is lethargic, gagging, and cyanotic. Which of the following is an appropriate action for the nurse to take?
A. Induce vomiting with syrup of ipecac
B. Insert a NG tube and administer activated charcoal
C. Prepare for intubation with a cuffed endotracheal tube
D. Administer chelation therapy using defroxamine mesylate

C

A. Inducing vomiting= CONTRAININDICATED
B. Activated charcoal is for aspirin poisoning
C. CORRECT!
D. Chelation therapy= lead poisoning treatment