A 5-year-old child is brought to the emergency department after ingesting diphenhydramine (Benadryl). The child is uncoordinated and agitated. The nurse observes that the child's face is flushed and that the heart rate is 110 beats per minute

Question

The nurse will expect to:
a. administer atropine to reverse the adverse effects.
b. give diazepam to prevent seizures.
c. give activated charcoal to absorb the drug.
d. prepare to provide mechanical ventilation.

Answer 1

ANS: C
In acute toxicity, patients present with agitation, a flushed face, tachycardia, and uncoordinated movements. There is no specific antidote, so drug removal is the focus of treatment, starting with activated charcoal to absorb the drug, followed by a cathartic to enhance excretion. Atropine would cause an increase in the heart rate. Diazepam is a central nervous system (CNS) depressant and is contraindicated, because diphenhydramine is also a CNS depressant. Mechanical ventilation is not indicated with this presentation of symptoms, although cardiovascular collapse may eventually develop.