A nurse is caring for a client prescribed acetaminophen as needed for pain relief. The nurse knows acetaminophen should not exceed 4 grams per day. Name three (3) manifestations of toxicity the nurse should monitor for.
Suggested Pharmacology Learning Activity: Pain Medications
A client has been receiving IV paclitaxel for the past week for treatment of ovarian cancer. Identify an assessment finding that is a priority to report to the provider?
Suggested Pharmacology Learning Activity: Chemotherapy Agents
A client is refusing to take morning medications. How should the nurse respond?
A 22-year-old client is hard to awake after taking diazepam by mouth. It is suspected she overdosed on the medication. What are two (2) measure the nurse anticipates will take place to address the acute toxicity with diazepam.
Regarding acetaminophen toxicity monitoring, three key manifestations the nurse should monitor for include:
Nausea and vomiting. Acetaminophen toxicity can cause nausea and vomiting. This is one of the earliest signs of potential overdose.
Abdominal pain. Upper abdominal pain may develop within the first 24 hours after an overdose.
Lethargy and confusion. As toxicity worsens, the client may become lethargic, confused, and develop jaundice as liver damage progresses.
For the client receiving paclitaxel chemotherapy, an assessment finding of highest priority to report to the provider would be signs of anaphylaxis or other severe allergic reaction. Paclitaxel is associated with potential severe allergic reactions, so any rash, itching, swelling, difficulty breathing or other reaction symptoms should be promptly reported.
In responding to a client who refuses morning medications, the nurse should first determine the reason for refusal through respectful questioning. The nurse may then provide education on the importance of treatment adherence and address any concerns the client has about their medications. If refusal persists despite education, the nurse should notify the provider to determine if any medication adjustments are needed. The nurse aims to empower the client’s autonomy while protecting their health.
For a client suspected of diazepam overdose, two measures the nurse anticipates include:
Airway management and monitoring of respiratory status. Diazepam overdose can cause respiratory depression, so airway patency and breathing effectiveness need close watch.
Gastric lavage or activated charcoal administration. Activated charcoal is often given to limit diazepam absorption from the gastrointestinal tract after an overdose. Gastric lavage may also be considered within one hour of ingestion.
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