MORTON 10E CH 56 - Drug Overdose and Poisoning FINAL

Proper storage and labeling of poisons

A 2-year-old has been resuscitated after ingestion of a cleaning solution. As part of discharge teaching, what is the most important information for the nurse to include?

Insert a nasogastric tube for lavage.

A child has ingested an unknown amount of household bleach, an alkaline substance. The child is currently tachypneic and lethargic. What is the nursing priority treatment?

Flumazenil (Romazicon)

A patient has arrived at the emergency department via ambulance. The EMT states, "She is barely responsive. She took all of the Ativan in this bottle." What medication should the nurse prepare to administer to the patient?

Cocaine

A patient has been admitted to the emergency department after ingesting an unknown substance. The nurse finds agitation, tachycardia, hypertension, and episodes of tonic-clonic muscle movements. Arterial blood gases reveal normal oxygenation and metabolic acidosis. What ingested substance does the nurse most suspect?

Verify that the ingested pills will be adsorbed by activated charcoal.

A patient has swallowed a large amount of pills. Activated charcoal, an adsorbent, is ordered to reduce toxic absorption. For best use of this substance, what action does the nurse initiate?

The patient has metabolic acidosis.

A patient in the intensive care unit is in acute renal failure secondary to acute tubular necrosis from a nephrotoxic medication and has an anion gap of 20 mEq/L. What does this laboratory value indicate?

Jimson weed

A patient is admitted to the emergency department after ingesting a large amount of an unknown substance while at a beach party. The nurse finds delirium, dry and flushed skin, dilated pupils, fever, decreased bowel sounds, and tachycardia. Urinary catheter insertion shows urinary retention. What ingested substance does the nurse most suspect?

Position the patient in the left lateral decubitus position with his head down.

A patient is admitted to the emergency department after ingesting a large number of tablets. Gastric lavage is ordered. What is the best nursing action during this procedure?

Depressed respiratory rate and volume

A patient is admitted to the emergency department after ingesting an unknown amount of a mixed substance containing cocaine and an opioid. What nursing assessment finding would indicate that the patient's life is in immediate danger?

"Chelation therapy will remove toxic levels of metals from the body."

A patient is receiving chelation therapy. What would the nurse explain to the patient is the purpose of chelation therapy?

Educate the parents on methods to child-proof the home so that the child will not have access to various harmful materials.

A toddler is being discharged from the hospital after being monitored for 24 hours due to a possible ingestion of household cleaner. What priority instruction should be provided to the parents before discharge?

Electrolyte studies Serum osmolality test Liver panel Acetaminophen level

An adolescent patient has arrived at the emergency department via ambulance after friends reported that she ingested a large quantity of unknown pills after having an argument with her boyfriend. The patient is combative and refuses to divulge the type of pills that she ingested. What lab studies should be performed at this time? Select all that apply.

Make a home health referral for evaluation of resources and medication dispensing.

An elderly patient is being treated after taking too much cardiac medication. The patient states, "I didn't mean to do it. I can't see as well as I used to and can't see the writing on the medication labels." What intervention by the discharge planning nurse would help prevent this from occurring again?

Activated charcoal

During the initial treatment of a patient with a poisoning or overdose, treatments to prevent absorption and to enhance elimination of the agent are of primary importance. What substance does the nurse administer to enhance elimination of an orally ingested alkaline caustic substance?

Administer naloxone (Narcan).

The nurse administers morphine sulfate IV to a patient for complaints of abdominal pain. The order was for 2 mg and the nurse realized that she gave the patient 10 mg. The patient's respiratory rate is 10 and she is unresponsive. What is the nurse's priority intervention at this time?

Refer the patient to a comprehensive treatment program.

The nurse is assigned to a patient who has been in the hospital for 24 hours with a diagnosis of acute alcohol intoxication. The patient states, "I am so stressed out in my marriage and with my job. Drinking is the only way that I can relieve that stress." What priority intervention would be beneficial for this patient?

Protect the airways of rescuers.

The nurse is caring for a patient who has inhaled an airborne toxin. What is the priority of care?

Irrigate eyes for 15 to 30 minutes with tap water.

The nurse is providing initial care for a patient who has experienced an ocular splash injury of a toxic liquid. What is the priority of care?

Continuous cardiac monitoring

The patient has been admitted to the CCU after taking a large amount of cocaine accompanied by large amounts of opioid. Initial detoxification was started in the emergency department. The patient is currently intubated and on mechanical ventilation. To identify life-threatening complications from these substances, what is the nursing priority?

Respirations 10 breaths per/minute

The patient has been found to have a defective and leaking fentanyl (Sublimaze) patch used for severe pain from recurring migraine headaches. What observations by the nurse indicate complications from this defect?

Gastric lavage

The patient has been taking amitriptyline (Elavil) for neuropathic pain in the lower extremities. He comes into the emergency room stating, "I took 15 of them right before I got here. I was tired of it all but should never have done this. Someone help me!" What intervention can help prevent absorption of the medication?

Altered level of consciousness

The patient has experienced an accidental salicylate overdose. Urine alkalinization with intravenous sodium bicarbonate solution is ordered. What symptom, if found by the nurse, most indicates a complication of this therapy?

Remove clothing and shower for 15 to 30 minutes.

The patient has extensive dermal exposure to a dermal toxin. What is the nursing priority of care?