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A 46-year-old patient is 2 days postoperative from a fractured ankle that was
repaired with internal fixation. The patient has a history of alcoholic cirrhosis and
is 30 lb overweight. In addition to intravenous (IV) antibiotics, the patient is
receiving acetaminophen for pain and fever reduction.
What factors, if any, in the patient's history would cause the nurse to question the
order for acetaminophen? - ✔✔✔ANSWER-The fact that the patient has a history
of liver cirrhosis would cause concern for the nurse. This is because, given the
compromised state of the patient's liver, the metabolism of the medication may be
impacted. Acetaminophen can also be toxic to the liver.
, For hepatically compromised patients, the proper dose of acetaminophen is ____
mg or lower. Or a different base medication other than acetaminophen may be
needed. - ✔✔✔ANSWER-2000
The patient in above case was discharged home on acetaminophen. After a few
days, the granddaughter of the patient visits and accidentally swallowed 30 tablets
of acetaminophen. At the emergency department, the nurse anticipates that the
child will receive which medication? - ✔✔✔ANSWER-acetylcysteine
How does acetylcysteine work? - ✔✔✔ANSWER-by preventing the hepatotoxic
metabolites of acetaminophen from forming
Acetylcysteine is most effective when given within _____ hours of acetaminophen
overdose. - ✔✔✔ANSWER-10
The home health nurse is following the patient at home. The patient is continuing
to take acetaminophen for pain. The patient is also exhibiting the following
behaviors:
A) Eating large amounts of green leafy vegetables
B) Eating apples and bananas for snacks
C) Drinking six beers over 2 days
D) Taking an over-the-counter H2 antagonist
Which behavior would cause the nurse the most concern? - ✔✔✔ANSWER-C)
Drinking six beers over 2 days