Author Question: A migrant worker presents to the emergency department with signs of an acute, recent organophosphate ... (Read 23 times)

arivle123 · **on:** Jul 23, 2018

A migrant worker presents to the emergency department with signs of an acute, recent organophosphate poisoning exposure. Which treatment plan should the nurse expect?

1. Treat the symptoms with echothiophate.
2. Keep the client relaxed and quiet; administer no medications.
3. Administer a stat dose of pralidoxime as an immediate antidote.
4. Give neostigmine as the antidote.

Question 2

The nurse is preparing discharge instructions for a client who is prescribed neostigmine (Prostigmin). What should be included in this client's discharge teaching?

Standard Text: Select all that apply.
1. Practice home safety measures.
2. Take the medication with food, milk, or a small snack.
3. Notify the health care provider if experiencing tremors, dizziness, or urinary retention.
4. Report to the health care provider any changes in muscle weakness that occur 1 or 3 hours after taking.
5. Stop taking the medication if shortness of breath occurs.

gabrielle_lawrence · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 3
Rationale 1: Echothiophate is not an antidote; it would have the opposite effect.
Rationale 2: Organophosphate poisoning requires immediate life-saving interventions.
Rationale 3: The nurse should expect to administer a stat dose of pralidoxime or atropine as an immediate antidote.
Rationale 4: Neostigmine is not an antidote; it would have the opposite effect.
Global Rationale: The nurse should expect to administer a stat dose of pralidoxime or atropine as an immediate antidote. Echothiophate is not an antidote; it would have the opposite effect. Organophosphate poisoning requires immediate life-saving interventions. Neostigmine is not an antidote; it would have the opposite effect.

Answer to Question 2

Correct Answer: 1,2,3,4
Rationale 1: Home safety measures need to be reviewed with the client who is prescribed neostigmine (Prostigmin). The client could experience muscle fatigue and orthostatic hypotension, which could precipitate falls.
Rationale 2: Administering the medication with food helps to minimize adverse effects.
Rationale 3: These are signs of excessive autonomic nervous system stimulation and could indicate an overdose.
Rationale 4: Muscle weakness within 1 hour of a dose may indicate overdosing, and muscle weakness within 3 hours of a dose may indicate underdosing.
Rationale 5: If shortness of breath occurs, the client should seek medical attention because this could be a sign of a potential overdose. The client should not be instructed to stop taking this medication.
Global Rationale: Home safety measures need to be reviewed with the client who is prescribed neostigmine (Prostigmin). The client could experience muscle fatigue and orthostatic hypotension, which could precipitate falls. Administering the medication with food helps to minimize adverse effects. Tremors, dizziness, or urinary retention are signs of excessive autonomic nervous system stimulation and could indicate an overdose. Muscle weakness within 1 hour of a dose may indicate overdosing, and muscle weakness within 3 hours of a dose may indicate underdosing. If shortness of breath occurs, the client should seek medical attention because this could be a sign of a potential overdose. The client should not be instructed to stop taking this medication.