NU410 Exam 4 Guide With
Complete Solution
Lyme Disease Stage I - ANSWER - Within 4 weeks after bite, treated with
doxycycline or penicillin
- "Bulls eye rash"
- Flulike symptoms
Lyme Disease Stage II - ANSWER - 4-10 weeks after bite
- Joint pain, memory loss, poor motor coordination, meningitis
Lyme Disease Stage III - ANSWER Arthritis, neuropathy, myalgia, myocarditis
Poisoning Treatment Goals - ANSWER - Remove or inactivate poison before
it is absorbed
- Provide supportive care in maintaining vital organs systems
- Administer specific antidotes
- Implement tx to hasten elimination of the poison
Alkaline Ingested Poisons - ANSWER Lye, drain cleaners, toilet bowl cleaners,
bleach, nonphosphate detergents, oven cleaners, button batteries
Acidic Ingested Posions - ANSWER - Toilet bowl cleaners, pool cleaners,
metal cleaners; rust removers, battery acid
- Bleach is mixed with an acid-containing toilet bowl cleaner, result will be
the release of deadly chlorine gas
,Ingested Poisons - ANSWER - Can be corrosive
- Corrosive poisons include alkaline & acid agents that cause tissue
destruction after coming into contact with mucous membranes
Measures to remove the toxin or decrease its absorption in patients with
ingested poisons - ANSWER - Use of emetics
- Gastric lavage
- Activated charcoal
- Cathartic when appropriate
- Administration of a specific antagonist as early as possible
- Other measures may include diuresis, dialysis or hemoperfusion
What don't want you to do in patients who've ingested corrosive poisonous
agents - ANSWER Do not induce vomiting as cause destruction of tissues by
contact
True or False: A corrosive poison is an both an acidic and alkaline agent that
causes tissue destruction after contact - ANSWER True
Carbon Monoxide Poisoning - ANSWER - May occur as a result of industrial
or household incident or attempted suicide (fire suppression & motor vehicle
exhaust)
- Colorless, odorless, & tasteless gas
Carbon Monoxide Poisoning Patho - ANSWER - Prevents O2 binding with
RBC, thereby reducing O2-carrying capacity of blood
- Hmg absorbs to CO 200 times faster than it absorbs O2
,- Result is called carboxyhemoglobin & it does not transport O2
Carbon Monoxide Poisoning S/S - ANSWER - May appear intoxicated (from
cerebral hypoxia), headache, muscular weakness, palpitation, dizziness, &
confusion which can progress into coma
- Skin can range from cherry-red (hallmark) to cyanotic to pale
- Pulse ox is not valid as hmg is well saturated (but not with O2, rather CO)
Carbon Monoxide Poisoning Nurse Management - ANSWER - Immediate tx
- Reverse cerebral & myocardial hypoxia & to hasten elimination of carbon
monoxide
- Carry patient to fresh air
- Loosen all tight clothing
- Initiate CPR if required; administer 100% O2
- Prevent chilling; wrap in blankets
- Keep patient quiet
- Do not allow patient to smoke or drink alcohol
Carbon Monoxide Poisoning Medical Management - ANSWER - 100% O2 is
administered at atmospheric or preferably hyperbaric pressures to reverse
hypoxia & accelerated elimination of CO
- O2 is administered until CO level is less than 5%
- When unintentional CO poisoning occurs, contact health department
- A psychiatric consultation is warranted if poisoning was determined to be a
, suicide attempt
True or False: Carboxyhemoglobin is hemoglobin bound to carbon monoxide
and therefore is unable to bind with oxygen, resulting in hypoxemia -
ANSWER True
Management of the Patient With Chemical Burns - ANSWER - Severity of
injury depends on the mechanism of action of the substance, the penetrating
strength & concentration, & the amount of skin exposed to the agent
- Immediately flush skin with running water from a shower, hose, or faucet
- Note: Lye or white phosphorus should be brushed off skin dry
- Protect health care personnel from substance
- Determine the substance
- Some substances may require prolonged flushing or irrigation
- Follow-up care includes reexamination of area at 24 hours, 72 hours, & 7
days
Food Poisoning - ANSWER - Sudden illness that occurs after ingestion of
contaminated food or drink
- Botulism is a serious form of food poisoning that requires continual
surveillance
- Key to tx is determining source & type of food poisoning
- Monitor F&E
Complete Solution
Lyme Disease Stage I - ANSWER - Within 4 weeks after bite, treated with
doxycycline or penicillin
- "Bulls eye rash"
- Flulike symptoms
Lyme Disease Stage II - ANSWER - 4-10 weeks after bite
- Joint pain, memory loss, poor motor coordination, meningitis
Lyme Disease Stage III - ANSWER Arthritis, neuropathy, myalgia, myocarditis
Poisoning Treatment Goals - ANSWER - Remove or inactivate poison before
it is absorbed
- Provide supportive care in maintaining vital organs systems
- Administer specific antidotes
- Implement tx to hasten elimination of the poison
Alkaline Ingested Poisons - ANSWER Lye, drain cleaners, toilet bowl cleaners,
bleach, nonphosphate detergents, oven cleaners, button batteries
Acidic Ingested Posions - ANSWER - Toilet bowl cleaners, pool cleaners,
metal cleaners; rust removers, battery acid
- Bleach is mixed with an acid-containing toilet bowl cleaner, result will be
the release of deadly chlorine gas
,Ingested Poisons - ANSWER - Can be corrosive
- Corrosive poisons include alkaline & acid agents that cause tissue
destruction after coming into contact with mucous membranes
Measures to remove the toxin or decrease its absorption in patients with
ingested poisons - ANSWER - Use of emetics
- Gastric lavage
- Activated charcoal
- Cathartic when appropriate
- Administration of a specific antagonist as early as possible
- Other measures may include diuresis, dialysis or hemoperfusion
What don't want you to do in patients who've ingested corrosive poisonous
agents - ANSWER Do not induce vomiting as cause destruction of tissues by
contact
True or False: A corrosive poison is an both an acidic and alkaline agent that
causes tissue destruction after contact - ANSWER True
Carbon Monoxide Poisoning - ANSWER - May occur as a result of industrial
or household incident or attempted suicide (fire suppression & motor vehicle
exhaust)
- Colorless, odorless, & tasteless gas
Carbon Monoxide Poisoning Patho - ANSWER - Prevents O2 binding with
RBC, thereby reducing O2-carrying capacity of blood
- Hmg absorbs to CO 200 times faster than it absorbs O2
,- Result is called carboxyhemoglobin & it does not transport O2
Carbon Monoxide Poisoning S/S - ANSWER - May appear intoxicated (from
cerebral hypoxia), headache, muscular weakness, palpitation, dizziness, &
confusion which can progress into coma
- Skin can range from cherry-red (hallmark) to cyanotic to pale
- Pulse ox is not valid as hmg is well saturated (but not with O2, rather CO)
Carbon Monoxide Poisoning Nurse Management - ANSWER - Immediate tx
- Reverse cerebral & myocardial hypoxia & to hasten elimination of carbon
monoxide
- Carry patient to fresh air
- Loosen all tight clothing
- Initiate CPR if required; administer 100% O2
- Prevent chilling; wrap in blankets
- Keep patient quiet
- Do not allow patient to smoke or drink alcohol
Carbon Monoxide Poisoning Medical Management - ANSWER - 100% O2 is
administered at atmospheric or preferably hyperbaric pressures to reverse
hypoxia & accelerated elimination of CO
- O2 is administered until CO level is less than 5%
- When unintentional CO poisoning occurs, contact health department
- A psychiatric consultation is warranted if poisoning was determined to be a
, suicide attempt
True or False: Carboxyhemoglobin is hemoglobin bound to carbon monoxide
and therefore is unable to bind with oxygen, resulting in hypoxemia -
ANSWER True
Management of the Patient With Chemical Burns - ANSWER - Severity of
injury depends on the mechanism of action of the substance, the penetrating
strength & concentration, & the amount of skin exposed to the agent
- Immediately flush skin with running water from a shower, hose, or faucet
- Note: Lye or white phosphorus should be brushed off skin dry
- Protect health care personnel from substance
- Determine the substance
- Some substances may require prolonged flushing or irrigation
- Follow-up care includes reexamination of area at 24 hours, 72 hours, & 7
days
Food Poisoning - ANSWER - Sudden illness that occurs after ingestion of
contaminated food or drink
- Botulism is a serious form of food poisoning that requires continual
surveillance
- Key to tx is determining source & type of food poisoning
- Monitor F&E
