Peds Final Review - Poisonings Flashcards
Poisoning, particularly by ingestion, is common cause of childhood injury and illness
Most poisonings occur in children under the age of 6, with a peak at age 2
The exploratory behavior, curiosity, and oral-motor activity of early childhood place the hild at risk for poisonings.
About 90% of poisonings occur in the home
Nursing Assessment:
- Child found near source of poison
- Gastrointestinal disturbance: nausea, abdominal pain, diarrhea, vomiting
- Burns of mouth, pharynx
- Respiratory distress
- Seizure, changes in level of consciousness
- Cyanosis
- Shock
Nursing Diagnosis
Risk for poisoning related to …..
Deficient knowledge (home safety) related to…..
Nursing interventions
- Identify the poisonous agent quickly!
- Assess the child’s respiratory, cardiac, and neurologic status
- Instruct parent to bring any emesis, stool, etc. to the emergency department
- Determine the child’s age and weight
Teach parents that it is not recommended to induce vomiting in any way because it may cause more damage.
Use of syrup of ipecac is no longer recommended.
LEAD POISONING
It is estimated that 2.2% of children under 6 years of age living in the United States have blood levels greater than 10 mcg/dl
Children 6 years of age and younger are most vulnerable to the effects of lead
Although numerous sources of lead can result in exposure in young children, the major cause of lead poisoning is deteriorating lead-based paint
Lead enters the body through ingestion, inhalation, or I the case of an unborn child, placental transfer when the mother is exposed.
The most common route is ingestion either from hand-to-mouth behavior via contaminated hands, fingers, toys, or pacifiers.
Or eating sweet-tasting loose paint chips found in a home built before 1950’s or in a play area.
Lead can affect any part of the body, but the renal, neurologic, and hematologic systems are the most seriously affected.
The blood lead level (BLL) test is currently used for screening and diagnosis.
Erythrocyte protoporphyrin (EP) test is a good indicator of early toxic effects of lead) and remains useful as a clinical tool, along with the BLL test, to help estimate the potential body burden of lead in a child.
Nursing Assessment:
Screen for lead poisoning using CDC guidelines of blood lead surveillance and other risk factor data collected over time to establish the status and risk of children throughout the state.
Nursing Assessment:
In areas without available data, universal screening is recommended.
A. All children should have a BlL test at the ages of 1 and 2 years
B. Collect blood in a capillary tube, and send to the lab
C. During collections, avoid contamination of the blood specimen and lead on the skin.
Nursing Assessment:
Any child between 3 and 6 years of age who has not been screened should also be tested.
Obtain a history of possible sources of lead in the child’s environment.
Do a physical assessment
Physical Assessment:
General signs:
Anemia Acute crampy abdominal pain Vomiting Constipation Anorexia Headache Lethargy Impaired growth
Physical Assessment:
Central nervous system signs (Early)
Hyperactivity Aggression Impulsiveness Decreased interest in play Irritability Short attention span
Physical Assessment:
Central nervous system signs (Late)
Mental retardation Paralysis Blindness Convulsions Coma Death
