NUR 2356 REVISION HANDBOOK 2026 BASIC
NURSING ASSESSMENT AND CLINICAL SKILLS
◉ can someone be asymptomatic if they have lead poisoning.
Answer: yes
◉ signs of anemia (lead poisoning).
Answer: pallor, fatigue, weakness, shortness of breath, headache,
tachycardia - because lead replaces iron in Hgb causing anemia
◉ Growth and developmental lags in lead poisoning.
Answer: learning difficulties
◉ Neurologic signs and symptoms of lead poisoning.
Answer: -Headache, irritability, difficulty concentrating, loss of
motor skills, paralysis, tremors
High levels: encephalopathy, seizures, and brain damage
◉ Gastrointestinal signs and symptoms of lead poisoning.
Answer: abdominal pain, failure to gain weight, weight loss,
vomiting, constipation
,◉ Lead poisoning diagnostics.
Answer: Blood lead level (BBL) test
-5mcg/dL = lead exposure
-45 mcg/dL = medical treatment required with chelation therapy
->70= mcg/dL = severe lead toxicity
◉ Therapeutic management of lead poisoning.
Answer: -Decontamination
-Chelation
-Supportive therapy
-Deterrence and prevention
◉ How do you decontaminate a person with lead poisoning?.
Answer: Xray of GI tract to see of lead is there. if it is, they flush it out
to stop absorption
◉ when to use Chelation therapy for lead poisoning.
Answer: -45-69 mcg/dL outpatient therapy with oral succorer and
parenteral disodium calcium edetate
->70 Hospitalization with dimercaprol and disodium calcium EDTA
-Monitor urinary output (possibly on 24 hour urine collection)
,◉ What do patients who have lead poisoning need in their diet?.
Answer: Adequate calcium, iron, and vitamin C
◉ Chelation drugs.
Answer: 1.Edetate calcium disodium (CaNA2EDTA)
2.Succimer (Chemet)
3.Dimercaprol (BAL in Oil)
◉ Information on Chelation drug Edetate calcium disodium
(CaNA2EDTA).
Answer: -Given IM or IV for 5 days
- Increase lead concentrations in CNS resulting in encephalopathy in
its with BLL >70 mcg/dL, used in combination with dimercaprol
◉ Information on chelation drug Succimer (Chemet).
Answer: -Given po every 8hrs x 5 days, then every 12 hours x 2 wks
-Capsules contain small beads that can be mixed with food. Cannot
be given through a syringe
◉ Information on chelation drug Dimercaprol (BAL in Oil).
Answer: -Drug of choice in severe lead toxicity cases (BLL >70)
, -IM every 4 hours with CaNA2EDTA started with dose 2
-Do not give with peanut allergy because it is made with peanut oil
-No iron supplements if receiving Dimercaprol because it can form
toxic complex if mixed with iron
◉ Nursing interventions with lead poisoning.
Answer: Monitoring parameters
-Blood lead levels
-Monitor fluid intake and urine output
-Seizure precautions
Dietary Considerations
-High iron
-Limit milk intake to 24 hours
-Adequate calcium and vitamin c
Prevention - screening
-Nutrition education: iron rich foods, calcium rich foods, vitamin c
rich foods
◉ Define sickle cell disease.
Answer: Sickle cell disease is a group of disorders that affects
hemoglobin. People with this disorder have atypical hemoglobin
molecules called hemoglobin S, which can distort red blood cells into
a sickle or crescent shape
NURSING ASSESSMENT AND CLINICAL SKILLS
◉ can someone be asymptomatic if they have lead poisoning.
Answer: yes
◉ signs of anemia (lead poisoning).
Answer: pallor, fatigue, weakness, shortness of breath, headache,
tachycardia - because lead replaces iron in Hgb causing anemia
◉ Growth and developmental lags in lead poisoning.
Answer: learning difficulties
◉ Neurologic signs and symptoms of lead poisoning.
Answer: -Headache, irritability, difficulty concentrating, loss of
motor skills, paralysis, tremors
High levels: encephalopathy, seizures, and brain damage
◉ Gastrointestinal signs and symptoms of lead poisoning.
Answer: abdominal pain, failure to gain weight, weight loss,
vomiting, constipation
,◉ Lead poisoning diagnostics.
Answer: Blood lead level (BBL) test
-5mcg/dL = lead exposure
-45 mcg/dL = medical treatment required with chelation therapy
->70= mcg/dL = severe lead toxicity
◉ Therapeutic management of lead poisoning.
Answer: -Decontamination
-Chelation
-Supportive therapy
-Deterrence and prevention
◉ How do you decontaminate a person with lead poisoning?.
Answer: Xray of GI tract to see of lead is there. if it is, they flush it out
to stop absorption
◉ when to use Chelation therapy for lead poisoning.
Answer: -45-69 mcg/dL outpatient therapy with oral succorer and
parenteral disodium calcium edetate
->70 Hospitalization with dimercaprol and disodium calcium EDTA
-Monitor urinary output (possibly on 24 hour urine collection)
,◉ What do patients who have lead poisoning need in their diet?.
Answer: Adequate calcium, iron, and vitamin C
◉ Chelation drugs.
Answer: 1.Edetate calcium disodium (CaNA2EDTA)
2.Succimer (Chemet)
3.Dimercaprol (BAL in Oil)
◉ Information on Chelation drug Edetate calcium disodium
(CaNA2EDTA).
Answer: -Given IM or IV for 5 days
- Increase lead concentrations in CNS resulting in encephalopathy in
its with BLL >70 mcg/dL, used in combination with dimercaprol
◉ Information on chelation drug Succimer (Chemet).
Answer: -Given po every 8hrs x 5 days, then every 12 hours x 2 wks
-Capsules contain small beads that can be mixed with food. Cannot
be given through a syringe
◉ Information on chelation drug Dimercaprol (BAL in Oil).
Answer: -Drug of choice in severe lead toxicity cases (BLL >70)
, -IM every 4 hours with CaNA2EDTA started with dose 2
-Do not give with peanut allergy because it is made with peanut oil
-No iron supplements if receiving Dimercaprol because it can form
toxic complex if mixed with iron
◉ Nursing interventions with lead poisoning.
Answer: Monitoring parameters
-Blood lead levels
-Monitor fluid intake and urine output
-Seizure precautions
Dietary Considerations
-High iron
-Limit milk intake to 24 hours
-Adequate calcium and vitamin c
Prevention - screening
-Nutrition education: iron rich foods, calcium rich foods, vitamin c
rich foods
◉ Define sickle cell disease.
Answer: Sickle cell disease is a group of disorders that affects
hemoglobin. People with this disorder have atypical hemoglobin
molecules called hemoglobin S, which can distort red blood cells into
a sickle or crescent shape
