Nokea
A child with diazepam (Valium) poisoning has been admitted to the emergency department. What antidote does the nurse anticipate being prescribed?
- A. Succimer (Chemet)
- B. EDTA (Versenate)
- C. Flumazenil (Romazicon)
- D. Octreotide acetate (Sandostatin)
Correct Answer: C
Rationale: The antidote for diazepam (Valium) poisoning is flumazenil (Romazicon). Succimer (Chemet) and EDTA (Versenate) are antidotes for heavy metal poisoning. Octreotide acetate (Sandostatin) is an antidote for sulfonylurea poisoning.
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A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. What should the nurse suspect?
- A. Unintentional injury
- B. Shaken baby syndrome
- C. Congenital neurologic problem
- D. Sudden infant death syndrome (SIDS)
Correct Answer: B
Rationale: Shaken baby syndrome causes internal bleeding but may have no external signs. Unintentional injury would not cause these injuries. With unintentional injuries, external signs are usually present. Congenital neurologic problems would usually have signs of abnormal neurologic anatomy. SIDS does not usually have identifiable injuries.
An awake, alert 4-year-old child has just arrived at the emergency department after an ingestion of aspirin at home. The practitioner has ordered activated charcoal. The nurse administers charcoal in which manner?
- A. Giving half of the solution and then repeating the other half in 1 hour
- B. Mixing with a flavorful beverage in an opaque container with a straw
- C. Serving it in a clear plastic cup so the child can see how much has been drunk
- D. Administering it through a nasogastric tube because the child will not drink it because of the taste
Correct Answer: B
Rationale: Although activated charcoal can be mixed with a flavorful sugar-free beverage, it will be black and resemble mud. When it is served in an opaque container, the child will not have any preconceived ideas about its being distasteful. The ability to see the charcoal solution may affect the childs desire to drink the solution. The child should be encouraged to drink the solution all at once. The nasogastric tube would be traumatic. It should be used only in children who cannot be cooperative or those without a gag reflex.
What is probably the most important criterion on which to base the decision to report suspected child abuse?
- A. Inappropriate response of child
- B. Inappropriate parental concern for the degree of injury
- C. Absence of parents for questioning about childs injuries
- D. Incompatibility between the history and injury observed
Correct Answer: D
Rationale: Conflicting stories about the accident are the most indicative red flags of abuse. The child or caregiver may have an inappropriate response, but this is subjective. Parents should be questioned at some point during the investigation.
A child with acetaminophen (Tylenol) poisoning has been admitted to the emergency department. What antidote does the nurse anticipate being prescribed?
- A. Carnitine (Carnitor)
- B. Fomepizole (Antizol)
- C. Deferoxamine (Desferal)
- D. N-acetylcysteine (Mucomyst)
Correct Answer: D
Rationale: The antidote for acetaminophen (Tylenol) poisoning is N-acetylcysteine (Mucomyst). Carnitine (Carnitor) is an antidote for valproic acid (Depakote), fomepizole (Antizol) is the antidote for methanol poisoning, and deferoxamine (Desferal) is the antidote for iron poisoning.
The nurse suspects that a child has ingested some type of poison. What clinical manifestation would be most suggestive that the poison was a corrosive product?
- A. Tinnitus
- B. Disorientation
- C. Stupor, lethargy, and coma
- D. Edema of the lips, tongue, and pharynx
Correct Answer: D
Rationale: Edema of the lips, tongue, and pharynx indicates a corrosive ingestion. Tinnitus is indicative of aspirin ingestion. Corrosives do not act on the central nervous system.