Question

A 22-year-old man has accidentally ingested about 200 ml of a lye-based liquid drain cleaner. Which treatment should the nurse be prepared to administer when the client arrives at the emergency department? A. A cathartic to promote elimination of the poisonous substance B. 30 ml of ipecac syrup followed by 240 ml of water to induce vomiting C. 150 ml of milk or water to dilute the ingested substance D. 75 g of activated charcoal to absorb the ingested chemical

Short answer

C. 150 ml of milk or water to dilute the ingested substance

Step-by-step solution

Understand the Problem

The problem involves treating a man who has ingested a lye-based liquid drain cleaner, which is a highly corrosive substance.

Review the Treatment Options

Evaluate the treatment options given: A cathartic, ipecac syrup, milk or water, and activated charcoal.

Analyze the Options

Consider the effects of each option: - Cathartics: Generally used for speeding up bowel movements but not effective for corrosive substances. - Ipecac syrup: Induces vomiting which can be harmful as it may cause re-exposure of the esophagus and mouth to the corrosive substance. - Milk or water: Dilutes the substance, which helps mitigate the corrosive damage. - Activated Charcoal: Used to absorb poisons but not effective for corrosive substances like lye.

Choose the Best Treatment

The best treatment for ingestion of a corrosive substance like lye is to dilute it, which can be done with milk or water. Hence, option C is most appropriate.

Key concepts

lye ingestion emergency care

Lye ingestion is a serious medical emergency requiring immediate attention. Lye is a caustic substance often found in products like drain cleaners that can cause severe burns and tissue damage upon contact. When someone ingests lye, the emphasis should be on preventing further injury and seeking rapid medical intervention.
Lye can cause significant harm to the mouth, throat, esophagus, and stomach. This is why inducing vomiting is dangerous, as it can re-expose these areas to the lye, causing more damage.
Upon arrival at the emergency department, the primary focus is on stabilizing the patient and diluting the ingested substance. This helps minimize further injury by reducing the concentration of lye in contact with bodily tissues.
Based on this understanding, the most immediate and effective treatment includes administering milk or water to help dilute the lye. Such dilution reduces the risk of severe burns, making prompt and precise action crucial.

corrosive substances treatment

Corrosive substances like lye can burn and destroy body tissue upon contact. The treatment for ingestion of corrosive substances hinges on preventing further tissue damage.
Inducing vomiting can worsen the situation, as the substance can damage the esophagus again while coming back up. Activated charcoal is also ineffective, as it does not neutralize or bind to corrosive substances like lye.
The most appropriate initial treatment is dilution. By giving the patient small amounts of milk or water, the corrosive substance's concentration is lowered, mitigating its corrosive effects. This dilution should be done carefully under medical supervision.
Additional care might include:

• Monitoring for signs of perforation and bleeding.
• Administering IV fluids to maintain hydration and electrolyte balance.
• Pain management and possibly antibiotics to prevent infection from chemical burns.

Close monitoring and support are crucial until the corrosive substance is thoroughly managed.

nursing interventions for poisoning

Nursing interventions play a critical role in managing poisoning cases. For lye ingestion, the nurse's primary responsibilities include:

• Quick assessment of the patient's vital signs and overall condition upon arrival.
• Ensuring the airway is clear to prevent aspiration and further respiratory complications.
• Administering the appropriate initial treatment, such as giving milk or water to dilute the substance.
• Preparing to assist with more advanced procedures, such as endoscopy, to assess the extent of internal damage.

Nursing care also involves educating the patient and family on preventing future incidents. After acute management, nurses may provide long-term care, including pain management, nutritional support if oral intake is compromised, and psychological support to cope with the trauma of poisoning.
Through diligent monitoring and comprehensive care, nurses help in ensuring the best possible outcomes for patients recovering from poisoning.