A mother brings her 17-year-old daughter to the emergency department. She states that the daughter took 40 extended-release acetaminophen tablets 8 hours ago. The nurse would antic-ipate an order for

a. activated charcoal.
b. high doses of antacids.
c. acetylcysteine (Mucomyst).
d. hemodialysis.


C
Liver damage can be minimized by giving acetylcysteine (Mucomyst), a specific antidote to acetaminophen. Acetylcysteine reduces injury by substituting for depleted glutathione in the reaction that converts the toxic metabolite of acetaminophen into its nontoxic form when given within 8 to 10 hours.
Because a period of 8 hours has elapsed, it is too late to administer activated charcoal; the medi-cation most likely has already been absorbed.
Antacids, even in high doses, will not correct the problem.
Overdose of acetaminophen is toxic to the liver, not the kidneys, therefore hemodialysis is not indicated.

Nursing

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A patient who has migraine headaches has been using sumatriptan [Imitrex] with good results, but reports frequent migraine recurrence 24 hours later. Which medication will the nurse expect the provider to order for this patient?

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A home health client participates in cultural health practices that the nurse feels may be detrimental to his health. In order to remain attentive to cultural sensitivity and provide appropriate cultural nursing care, the nurse should:

1. Explain the right and wrong of the client's treatment and try to persuade him to follow the scientific perspective. 2. Have the client's physician explain the care to the client in a firm but gentle manner. 3. Validate the client's practices and understand that for this client, it may be beneficial to continue with his preferences. 4. Try to negotiate with the client by exploring his views and then provide relevant scientific information.

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In a patient with ____________________ paralysis, the extremities move in an involuntary pattern, similar to muscle spasms.

Fill in the blank(s) with the appropriate word(s).

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