Supportive care of airway, breathing, and circulation takes priority over identifying the exact substance.
Before you read
Test yourself first: 4 questions
Question 1 of 4
Which is true about disclosing a medication error to the client?
Answer: B. Clients have a right to honest disclosure of errors that affect them; follow facility policy and involve the provider/risk management. Hiding an error violates ethics and often law.
Question 2 of 4
A client with preterm premature rupture of membranes at 32 weeks is admitted for expectant management. Which assessment finding should the nurse report immediately as a sign of intra-amniotic infection (chorioamnionitis)?
Answer: A. Maternal fever with uterine tenderness, maternal and fetal tachycardia, and foul-smelling or purulent amniotic fluid suggest chorioamnionitis, which mandates prompt treatment and usually delivery. These signs require immediate reporting; a normal temperature and clear fluid are reassuring.
Question 3 of 4
A child with epiglottitis arrives with drooling, tripod positioning, and stridor. The nurse should NOT:
Answer: B. Do NOT examine the throat or use a tongue depressor in suspected epiglottitis — it can trigger complete airway obstruction. Keep the child calm, give oxygen, and prepare for emergency airway management.
Question 4 of 4
A nurse is teaching a client with type 1 diabetes about sick-day management. Which instruction is most important to prevent diabetic ketoacidosis during illness?
Answer: B. During illness, stress hormones raise blood glucose and the body may still need insulin even when eating little. The key teaching is to continue taking insulin, monitor blood glucose and ketones frequently, and maintain hydration. Stopping insulin during illness is a common cause of DKA.
Keep the streak going with more questions like these, each with a full rationale.
What is poisoning general management?
Management centers on supporting the ABCs, identifying the toxin, and limiting absorption. Always contact Poison Control for guidance on specific agents and antidotes.
Key points to remember
- Supportive care of airway, breathing, and circulation takes priority over identifying the exact substance.
- Activated charcoal can adsorb many ingested toxins if given early, but is contraindicated for caustics, hydrocarbons, and decreased level of consciousness due to aspiration risk.
- Syrup of ipecac and induced vomiting are no longer recommended.
- Specific antidotes include naloxone for opioids, N-acetylcysteine for acetaminophen, flumazenil for benzodiazepines, and atropine for organophosphates.
- Caustic ingestions (acids/alkalis) should not be neutralized or induced to vomit due to re-injury risk.
- Carbon monoxide poisoning causes falsely normal pulse oximetry and is treated with 100% oxygen.
Nursing priorities
- Assess and support airway, breathing, and circulation first.
- Call Poison Control and identify the substance, amount, and time of exposure.
- Administer the appropriate antidote and decontaminate (skin/eye irrigation, activated charcoal when indicated).
- Establish IV access and monitor cardiac rhythm, mental status, and vital signs.
- Send labs and toxicology screens and protect the airway in the obtunded patient.
Labs & values
Patient teaching
- Keep the Poison Control number (1-800-222-1222) posted and call before treating.
- Store medications and chemicals in original, locked, child-proof containers away from children.
- Do not induce vomiting unless specifically directed by Poison Control.
- Install carbon monoxide detectors in the home.
Red flags: report now
- Decreasing level of consciousness threatens the airway - do not give oral charcoal to an unprotected airway.
- Never induce vomiting after caustic or hydrocarbon ingestion.
- Normal pulse ox does not rule out carbon monoxide poisoning - treat with 100% oxygen.
- Report new dysrhythmias, seizures, or rapidly worsening mental status immediately.
References
Clinical references for this topic
