Nursing Prioritization Delegation Assignment Q 72
A mother is so worried that her son took an unknown amount of children’s chewable vitamins at an unknown time. While in the ED, the child is alert and asymptomatic. What information should be directly stated to the physician?
A. The child was nauseated and vomited before arriving in the ED.
B. The child has been managed multiple times for unexpected injuries.
C. The child has been treated many times for the ingestion of toxic substances.
D. The ingested children's chewable vitamins contain iron.
Correct Answer: D. The ingested children’s chewable vitamins contain iron.
Iron is a toxic substance that can lead to severe bleeding, shock, hepatic failure, and coma. The antidote that can be used for severe cases of iron poisoning is deferoxamine. Iron poisoning is one of the most common toxic ingestion and one of the most deadly among children. Failure to diagnose and treat iron poisoning can have serious consequences including multi-organ failure and death.
Option A: During the first stage (0.5 to 6 hours), the patient mainly exhibits gastrointestinal (GI) symptoms including abdominal pain, vomiting, diarrhea, hematemesis, and hematochezia. The second stage (6 to 24 hours) represents an apparent recovery phase, as the patient’s GI symptoms may resolve despite toxic amounts of iron absorption.
Option B: This information needs further investigation but will not change the immediate diagnostic testing or treatment plan. Patients who have GI symptoms that resolve after a short period of time and have normal vital signs require supportive care and an observation period, as it may represent the second stage of iron toxicity.
Option C: Patients who are symptomatic or demonstrate signs of hemodynamic instability require aggressive management and admission to an intensive care unit. Deferoxamine, a chelating agent that can remove iron from tissues and free iron from plasma, is indicated in patients with systemic toxicity, metabolic acidosis, worsening symptoms, or a serum iron level predictive of moderate or severe toxicity.