A patient is brought to the emergency department by friends, who say that they were at a party where alcohol and a mix of barbiturates and benzodiazepines were all available
They tell the nurse that the patient was among the first to arrive at the party, which started several hours ago. The patient is nonresponsive and has pinpoint pupils and respirations of 6 breaths per minute. After oxygen has been administered, the nurse should prepare the patient for which intervention?
a. A central nervous system stimulant and IV fluids
b. Activated charcoal and flumazenil (Romazicon)
c. Gastric lavage and possible hemodialysis
d. Naloxone (Narcan) and a cathartic
ANS: C
Because time has elapsed, enough medication is present in the system to warrant elimination by hemodialysis, and any remainder in the stomach may be eliminated by gastric lavage. A central nervous system stimulant is contraindicated, and intravenous fluids do not address the overdose. Although activated charcoal may assist in absorption of medication in the gut, flumazenil will be effective only for the benzodiazepines. Naloxone, a narcotic antagonist, is not effective for barbiturates and benzodiazepines.
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