A young patient is brought to the emergency department by friends, who say they found him unresponsive at his home
The prescriber suspects that the patient was poisoned. During the assessment, the man mumbles a word and becomes comatose. The nurse should immediately prepare to administer:
a. activated charcoal.
b. intravenous dextrose.
c. intravenous flumazenil (Romazicon).
d. syrup of ipecac.
ANS: B
Intravenous (IV) dextrose should be given immediately for coma of unknown etiology, even if information on the blood glucose level is lacking. Flumazenil (Romazicon) is indicated for benzodiazepine overdose. Syrup of ipecac should not be administered to a patient with a decreased level of consciousness. Because the drug induces vomiting, the comatose patient would be at risk for aspiration. If administered within 30 minutes after poison ingestion, charcoal can absorb about 90% of the poison. If administered 60 minutes after poison ingestion, this is reduced to 37% absorption. Although poisoning is suspected, there is no indication of the time of ingestion. Therefore, activated charcoal would not be the best option for treatment.
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