Case NURSING 305-62175 iHuman Amka Oxendine

Case NURSING 305-62175 iHuman Amka Oxendine iHuman Amka Oxendine

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NURSING 305-62175 iHuman AmkaOxendineCASE STUDY

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iHuman Amka Oxendine- Pre-work & All Sections with Answer & SBAR note. 19 y/o F, 5’3”, 127 lbs. Dx: Acute acetaminophen ingestion

Brought vis EMS to ER with c/o abd pain with nausea. EMS reports ingestion of acetaminophenfor SI. 58kg.Full Code. VS q1hr x4, a2hr, q4hr. NPO. NKDA. SI precautions until psychiatrist

Deniesingestion ofsalicylates, ETOH or othersubstances within in 24 hr. Four hours later after wakinguphad second thoughts and call EMS. 58 kg. Full Code. VS q1hr x4, a2hr, q4hr. NPO. NIKA. SI precautions until psychiatrist

1. What is your primary concersfor this patient and what assessments and interventions wouldbe associated with your concerns and why?

My primary concern would be to assess for Airway Breathing Circulation- SOB, CP, andpalpitations. I would assess for unusual bleeding as a priority. Next I would performa

neurovascular check, noting PERRLA. I would also be aware ofs/s of liver failure: anorexia, n/v, fatigue, excessive sweating and confusion. The interventionsI would perform:

1. Assessing time of ingestion***, Quantity/Strength, and reason. 2. Consider evaluating for other co-ingestions(e.g.,salicylates, tricyclic antidepressants, ethanol, ethylene glycol, methanol) especially since thisis a known suicide attempt. 3. Since patients with acetaminophen toxicity can develop not only liver failure, but alsorenal

failure, coagulopathy due to liver failure, and acid base disturbances, will monitor for thefollowing additional labs (serum creatinine, urinalysis, lactic acid level, arterial bloodgas, venous blood gas). Serial labs will likely be needed to determine the clinical courseof thepatient. 4. Utilize oxygen therapy if pt is noted to be in respiratory distress. 5. Give IV fluid and draw labsfor Paracetamol blood level. 6. Provide antidote of N-acetylcysteine as prescribed. 7. Activated charcoal should be administered assoon as possible, usually within 1- 2 hoursof

the exposure as prescribed. 2. What medications do you anticipate the health care provider would prescribe while thepatient is in the hospital and why?

1. Activated charcoal to halt the absorption of acetaminophen in the stomachtypicallywithin 1-2 hours of exposure. It acts by binding to the pharmaceutical drugs or poisonsi.e. organophosphates and decreasing the systemic absorption of toxic agents.

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