Question

Scenario: Johnny Parker is a 4-year-old Hispanic male who ingested an unknown amount of liquid children’s Acetaminophen under the care of his aunt at 1130 on Wednesday. Johnny was brought to the emergency department, where he was given activated charcoal in suspension via PO

Please answer the following questions for the scenario .

4. 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 poison?

5. List ways in which the nurse can maintain family-centered care during a medical crisis. Can any aspects of the care being delegated to others?

6. 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?

Answer 1

4. 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 poison?

1. Children younger than 6 years of age
2. Activated charcoal, Gastric lavage, Increasing bowel motility, Syrup of ipecac (stimulation of vomit) is contraindicated for routine poison control treatment i. For Acetaminophen: Antidote: N-acetylcysteine given orally (Binds the poisonous forms of acetaminophen that are formed in the liver)
3. The child may be at risk for aspiration & can’t have anything & they may be out of it (stupor). Sometimes the child will be vomiting.

5. List ways in which the nurse can maintain family-centered care during a medical crisis. Can any aspects of the care being delegated to others?

Once the patient is stabilized you could welcome the family to the room to be with the patient while having the doctor interview them and explain what happened at home. The doctor would go over any procedures with the family. Encourage their involvement including family visitations, presence during procedures/interventions, family-centered rounds, family conferences. The family could comfort the child while procedures are taking place (iv’s, blood draws, injections), use distracting methods (singing, listening to music w/ headset, counting aloud, blowing bubbles to “blow the hurt away”. They can also bathe, feed, provide oral hygiene, hair care, etc. Have parent/assistant hold child down if not cooperating. Collaborate with others in team like respiratory therapist, etc.

6. 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?

• 2 to 4 hr after ingestion: Nausea, vomiting, sweating, and pallor
• 24 to 36 hr after ingestion: Improvement in condition
• 36 hr to 7 days or longer (hepatic stage): Pain in upper right quadrant, confusion, stupor, jaundice, and coagulation disturbances
• Final stage: Death or gradual recover