Author Question: A toddler is brought to the emergency department by ambulance. The parents state that they think the ... (Read 53 times)

jCorn1234 · **on:** Jul 23, 2018

A toddler is brought to the emergency department by ambulance. The parents state that they think the child got into something at a friend's house. The nursing assessment reveals stiffness in the face and neck and hyperreflexes.

The nurse is correct to suspect ingestion of which of the following agents?
a. Strychnine
b. Cocaine
c. Methamphetamine
d. Modafinil (Provigil)

Question 2

A patient comes to the clinic complaining of insomnia. In his health history, the patient reveals that he works in a coffee shop, and as a snack he has been eating a cup of chocolate-covered coffee beans daily in the late afternoon.

Based on the patient's statement, the nurse should assess for what other clinical manifestations? (Select all that apply.)
a. Vasodilation of blood vessels in the central nervous system
b. Elevated serum sodium levels
c. Diuresis
d. Bronchodilation
e. Nervousness

ladyjames123 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A
A common cause of strychnine poisoning is accidental ingestion from strychnine-based rodenticides. The first manifestation of poisoning is stiffness in the muscles of the face and neck, followed by a generalized increase in reflex excitability.
The assessment findings are inconsistent with cocaine or methamphetamine overdose.
The assessment findings are not consistent with modafinil overdose or ingestion.

Answer to Question 2

ANS: C, D, E
Caffeine, which the patient is ingesting from the coffee beans daily, causes relaxation of bronchial smooth muscle, which promotes bronchodilation, nervousness, and diuresis secondary to vasodilation of the blood vessels in the peripheral vascular system.
Caffeine causes vasoconstriction of the blood vessels in the central nervous system.
Caffeine does not elevate serum sodium levels.