Never induce vomiting after ingestion of a caustic substance or a hydrocarbon (risk of burns and aspiration).
Before you read
Test yourself first: 3 questions
Question 1 of 3
A controlled substance count at the change of shift does not match the record. What is the nurse's appropriate action?
Answer: A. A discrepancy in a controlled substance (narcotic) count must be reported immediately to the charge nurse or pharmacy and investigated per facility policy before the off-going nurse leaves. The discrepancy is never ignored or assumed to be a counting mistake.
Question 2 of 3
Which is correct medication storage and safety practice?
Answer: B. Store look-alike/sound-alike and high-alert meds separately with warnings, keep controlled substances locked and counted, and never pre-pour or leave meds unattended at the bedside.
Question 3 of 3
A client with a pheochromocytoma asks why the nurse avoids palpating the abdomen. What is the best response?
Answer: A. Palpating the abdomen over a pheochromocytoma can mechanically squeeze the tumor and trigger a sudden massive release of catecholamines, causing a hypertensive crisis. Deep abdominal palpation is therefore avoided. The concern is not infection, tumor seeding, or pain control.
Keep the streak going with more questions like these, each with a full rationale.
What is poison control?
The national Poison Control hotline (1-800-222-1222) guides home and clinical management. Key principle: call Poison Control first, do not induce vomiting, and prevention through safe storage is the priority.
Key points to remember
- The Poison Control number 1-800-222-1222 is available 24/7 and should be called before any home treatment.
- Syrup of ipecac is no longer recommended; inducing vomiting can cause aspiration and worsen caustic injury.
- Activated charcoal may be used in a facility for some ingestions but only with a protected airway.
- Caustic ingestions (drain cleaner, bleach) and hydrocarbons (gasoline, lighter fluid) should NOT be vomited.
- Common high-risk pediatric ingestions include iron, acetaminophen, button batteries, and cleaning agents.
- Bring the container or substance and an estimate of amount and time of ingestion to the emergency department.
Nursing priorities
- Assess and support airway, breathing, and circulation first.
- Call Poison Control (1-800-222-1222) immediately and follow their directions.
- Identify the substance, amount, and time of exposure and bring the container.
- Do NOT induce vomiting unless explicitly directed by Poison Control or a provider.
- Administer ordered antidotes or decontamination (skin/eye irrigation, charcoal) per protocol and monitor closely.
Patient teaching
- Store all medications, cleaners, and chemicals locked, up high, and in original containers.
- Save the Poison Control number 1-800-222-1222 in every phone and post it in the home.
- Use child-resistant caps but know they are not childproof; never call medicine 'candy'.
- Keep purses and bags with pills out of reach, a common source of grandparent medications.
Red flags: report now
- Never induce vomiting after ingestion of a caustic substance or a hydrocarbon (risk of burns and aspiration).
- A swallowed button battery is an emergency; it can erode the esophagus within hours, so seek immediate care.
- Decreased level of consciousness, seizures, or respiratory compromise require emergency stabilization before decontamination.
References
Clinical references for this topic
