章节:The Child with Health Problems Involving Ingestion, Nutrition, or Diet

SC
正确指数:100% 正确的次数:0 错误的次数:0 5237---A toddler is brought to the emergency department after ingesting an undetermined amount of drain cleaner. The nurse should expect to assist with which intervention first?

Saunders Comprehensive Review for the NCLEX-RN® Examination, 7e (Saunders Comprehensive Review for Nclex-Rn)

1. administering an emetic
2. securing the airway
3. performing gastric lavage
4. inserting an indwelling urinary (Foley) catheter

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正确答案:
2. securing the airway
解释 :
Drain cleaner almost always contains lye, which can burn the mouth, pharynx, and esophagus on ingestion. The nurse would be prepared to assist with procedures to secure the airway, which may include intubation or performing a tracheostomy. An emetic is contraindicated because, as the substance burns on ingestion, so too would it burn when vomiting. Additionally, the mucosa becomes necrotic, and vomiting could lead to perforations. Gastric lavage is contraindicated because the mucosa is burned from the ingestion of the caustic lye, causing necrosis. Gastric lavage also could lead to perforation of the necrotic mucosa. Insertion of an indwelling urinary (Foley) catheter would be indicated after the measures to remove the caustic substance have been started.