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66 Cards in this Set

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Most popular types of poisoning are?
Lead and acetaminophen poisoning
If ingested poison, what to do first?
Call poison control center, than 911 if they say so
If child is poisoned, do not administer __________
Syrup of Ipecac
Treat the child ____, not the poison
FIRST
Assessment of poison: find out?
what, when and how much substance entered the body
To absorb poison ______ is adminstered
Activated charcoal
_________ is used if activated charcoal does not absorb all the poison
Gastric lavage (stomach pumping)
Why do we not administer Emetic?
It is found to increase the risk of aspiration and when regurgitation of the poison re-damages the esophageal and pharyngeal mucosa
How much activated charcoal do we administer?
1g/kg unless the weight and amount of toxin ingested is known
Activated charcoal is administered how?
PO or via NGT **preferably PO
How do we prepare activated charcoal?
Mix it with diet soda and serve via straw in an opaque cup ( so they can't see black gritty substance they are drinking )
Why diet soda with activated charcoal?
No sugar helps the charcoal to bind to poison, sugar decreases the effect of charcoal
What should we tell parents to expect after child has consumed activated charcoal?
Expect black stool, diarrhea and sometimes vomiting
Characteristics of charcoal?
odorless, tasteless, fine black powder
Administer charcoal PO only to?
Conscious victim
Antidote for Acetaminophen (Tylenol)?
Acetylycysteine (Mucomyst)
Antidote for Carbon Monoxide?
Oxygen
Antidote for Opiod overdose?
Naloxone (Narcan)
Antidote for Benzodiazepines?
Flumazenil (Romazicon)
Antidote for Digoxin toxicity?
Digoxen-immune FAD (Digibind)
Antidote for Poisonous snake bites?
Anti-venim
Antidote for Heparin Toxicity?
Protamine Sulfate
Antidote for Coumadin Toxicity?
Vitamin K
Antidote for Cyanide?
Amyl Nitrate
Parents should not refer to medicine as?
Candy
Most common accidental drug poisoning in child? that occurs from acute ingestion.
Acetaminophen (Tylenol)
Large doses of Acetaminophen (Tylenol) does what to liver?
extensive damage
Person has Acetaminophen (Tylenol) overdose, can never take Acetaminophen (Tylenol) again unless what tests say its okay?
LFTs (liver function tests)
Elevated liver Enzymes:
-AST (SGOT)
SGOT -- Serum Aspartate Aminotransaminase
Elevated liver Enzymes:
-ALT (SGPT)
SGPT: Serum Alanine Aminotransaminase
Acetaminophen (Tylenol) overdose administer:
N-acetylcysteine (Mucomyst)
Mucomyst prevents _______ toxicity by binding with the breakdown product of Acetaminophen to prevent drug from binding to liver cells.
hepatyl toxicity
Mucumyst is administered ____ with a loading dose...than ___ more doses q_h
PO with a loading dose, after loading dose...17 more doses q4h
Characteristics of Mucomyst:
smells like rotten eggs
Prepare mucomyst by:
Diluting it in fruit juice
If mucomyst fails to remove all of toxin, administer:
Activated charcoal
For hospitalized child with Acetaminophen (Tylenol) toxicity, nurse should measure:
1. continue to observe child
2. monitory LFT, BUN, creatinine, electrolytes, glucose levels
3.monitory Acetaminophen (Tylenol) drug levels
Therapeutic levels for Acetaminophen (Tylenol):
10-30 mcg/ml
Toxic levels for Acetaminophen (Tylenol):
greater than > 200 mcg/ml
Caustric poisoning is ingestion of:
strong alkali or acids (draino, bleach, batteries)
For caustic poisoning, tell parents child must not:
VOMIT, this will burn the tissue necrosis in oral cavity, esophagus and stomach
ASA is?
Asprin: Acetylsalic acid
First symptoms of Asprin/Acetylsalic acid overdose:
N/V followed by rapid breathing (hypernea), tinnitus and diaphoresis
MOST COMMON: drowsiness, subtle confusion and hallucinations
Severe symptoms for Asprin/Acetylsalic acid overdose:
lightheadedness, fever, drowsiness, hyperactivity, confusion, seizures, rhabdomyolysis, difficulty breathing, hyperthermia, oliguria
Person has severe Asprin/Acetylsalic acid overdose, they will have which acid base imbalance?
Metabolic Acidosis, most of the time!
Treatment for person with Asprin/Acetylsalic acid overdose and metabolic acidosis:
Administer activated charcoal ASAP, and NaHCO3 IV: (sodium bicarbonate) and urinary alkalinization
Chelation therapy is used for:
deferoxamin (fesferal): severe Fe intoxication
Most common source of heavy metal poisoning:
lead
Treatment for lead poisoning
Chelation therapy
National goal for lead and children:
Eliminating blood lead levels > 10 mcg/dL among children 1-5 years of age by 2010
Most vulnerable age for lead poisoning:
children less than 6
Lead poisoning effects:
renal, hematoligic and neurologic systems: developing brain and nervous systems are especially vulnerable
Hematologic System:
Leads to hypochromic, microcytic anemia
makes RBCs appear pale under microscope
American academy of pediatrics recommends screening fro all children: b/w ages 9&12 mos and again at 24mos. .. screened with BLL (blood lead levels)...If results are ______________ must be confirmed by __________________
result > 10 mcg/dL (POSITIVE ) .... must be confirmed by secondary venous blood sample
After first BLL test, with result > 10 mcg/dL and after secondary venous blood sample, lead poisoning is present if:
Two successive blood lead levels of > 10 mcg/dL ... this result means lead poisoning is present
Acute lead poisoning if Venous BLL is __________
> 20 mcg/dL .... rescreen!!
Most important treatment/prevention for lead poisoning:
educate family
what do you do? Blood level b/w 10 - 14 mcg/dL ......
Rescreen to confirm
what do you do? BLL > 15-19 mcg/dL......
needs active intervention
what do you do? BLL > 20-44 mcg/dL.....
clinical management; environmental investigation, lead-hazard control
what do you do? BLL >45 mcg/dL......
Chelation therapy necessary (removes lead)
For chelation therapy of BLL >45 mcg/dL : adminster antagonist agents:
Edetate calcium disodium (EDTA)
BAL is only used in conduction with EDTA if BLL is .......
BLL > 70 mcg/dL
Specific gravity of urine must me _________ to administer EDTA
1.002-1.030
Most commonly used agents for chelation therapy is:
1.Succimer (Chemet)
2. Dimercaprol or dimercaptropanol (BAL)
3. Calcium disodium edetate (CaNa2EDTA) : commonly called edentate calcium disodium: EDTA
What does chelation therapy do?
Remove lead from circulating blood