A patient has been received in the emergency department for treatment of poison ingestion. Gastric lavage and placement of activated charcoal has been prescribed. The nurse would withhold this treatment and collaborate with the prescriber if which instances occur? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply

Question

1. The patient vomits.
2. The patient becomes unconscious.
3. The patient discloses that lithium was the drug taken.
4. Paramedics report that it has been 2 hours since the drug was taken.
5. The patient begins to pass copious amounts of watery diarrhea.

Answer 1

2,3,4
Rationale 1: It is not possible to determine if all the drug has been vomited or how much has already passed into the intestine.
Rationale 2: If protective airway reflexes are lost, gastric lavage is contraindicated.
Rationale 3: Activated charcoal does not bind well to lithium.
Rationale 4: Both of these interventions are more effective if performed within 1 hour of ingestion.
Rationale 5: It is unknown if the drug is passing in the diarrhea.

Global Rationale: If protective airway reflexes are lost, gastric lavage is contraindicated. Activated charcoal does not bind well to lithium. Both of these interventions are more effective if performed within 1 hour of ingestion. It is not possible to determine if all the drug has been vomited or how much has already passed into the intestine. It is unknown if the drug is passing in the diarrhea.