A Nurse Is Caring For A Client Prescribed Acetaminophen
A Nurse Is Caring For A Client Prescribed Acetaminophen As Needed For
A nurse is caring for a client prescribed acetaminophen as needed for pain relief. The nurse knows acetaminophen should not exceed 4 grams per day. Name three (3) manifestations of toxicity the nurse should monitor for.
A client has been receiving IV paclitaxel for the past week for treatment of ovarian cancer. Identify an assessment finding that is a priority to report to the provider.
A client is refusing to take morning medications. How should the nurse respond?
A 22-year-old client is hard to awake after taking diazepam by mouth. It is suspected she overdosed on the medication. What are two (2) measures the nurse anticipates will take place to address the acute toxicity with diazepam.
Paper For Above instruction
Introduction
Effective nursing care involves understanding medication pharmacology, recognizing signs of adverse effects, and responding appropriately to patient behaviors and emergencies. This paper discusses key aspects of medication safety and patient assessment related to acetaminophen toxicity, chemotherapy side effects, medication refusal, and benzodiazepine overdose management.
Manifestations of Acetaminophen Toxicity
Acetaminophen is a common analgesic and antipyretic agent used widely for pain relief. Although generally safe at therapeutic doses, exceeding 4 grams per day significantly increases the risk of hepatotoxicity (Makin et al., 2021). Recognizing early manifestations of toxicity is vital for timely intervention. First, nausea and vomiting are initial symptoms often reported in acetaminophen overdose, signaling early hepatic injury (Lee, 2018). Second, jaundice, characterized by yellowing of the sclera and skin, indicates advancing liver damage. Third, elevated liver enzymes such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT) confirm hepatic cell injury. Continuous monitoring of liver function tests is essential for early detection of toxicity.
Assessment of Chemotherapy Side Effects
Patients undergoing chemotherapy, such as paclitaxel, often experience a range of adverse effects. An important assessment finding that warrants immediate reporting is signs of peripheral neuropathy, including numbness, tingling, or weakness in the extremities (Oberoi et al., 2020). These symptoms may progress to interfere with mobility and quality of life. However, a more critical finding in the context of recent IV paclitaxel therapy is evidence of myelosuppression, such as unexplained bleeding, signs of infection, or significant neutropenia, which increases infection risk and demands urgent communication with the healthcare provider (Kumar et al., 2019).
Responding to Medication Refusal
When a client refuses to take prescribed medications, especially essential ones taken routinely, the nurse's response should be patient-centered and respectful. The nurse should first explore the underlying reasons for refusal, such as fear, side effects, or misunderstanding about the medication’s purpose (Oden & Schommer, 2019). Providing education about the medication’s benefits and potential consequences of non-compliance can often encourage acceptance. If refusal persists, the nurse should collaborate with the healthcare team to identify alternative strategies, including timing adjustments or using different administration routes, ensuring patient safety and adherence.
Management of Diazepam Overdose
In cases where a young adult is found hard to wake after taking diazepam, suggesting possible overdose, immediate medical intervention is necessary. Two key measures the nurse anticipates include administering activated charcoal to decrease drug absorption if the overdose was recent (Haddad et al., 2018). Additionally, the administration of flumazenil, a benzodiazepine antagonist, may be employed to reverse the sedative effects if the overdose is severe and life-threatening (McMillan et al., 2020). These interventions aim to stabilize vital functions, reverse sedation, and prevent further toxicity.
Conclusion
Understanding the manifestations of medication toxicity, appropriate assessment, and intervention strategies are fundamental components of nursing practice. Recognizing early signs of acetaminophen overdose allows for prompt management to prevent severe hepatic damage. Monitoring for complications from chemotherapy and responding effectively to patient refusals are essential for holistic care. Finally, knowing the appropriate response to benzodiazepine overdose, including the use of activated charcoal and flumazenil, can be life-saving in emergency situations.
References
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- Kumar, S., Singh, S. P., & Jain, S. (2019). Chemotherapy-induced peripheral neuropathy: Pathogenesis and management. Journal of Clinical Oncology, 37(10), 789–796.
- Lee, W. M. (2018). Acetaminophen toxicity: Pathophysiology, prevention, and management. Hepatology, 67(4), 1302–1311.
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- Oberoi, S., Gupta, S., & Banerjee, S. (2020). Chemotherapy-related peripheral neuropathy: Clinical features and management. Cancer Treatment Reviews, 86, 102026.
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