Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
66 Cards in this Set
- Front
- Back
|
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
|
