A patient in the clinic reports taking a handful of acetaminophen ...

[Marty]

A patient in the clinic reports taking a handful of acetaminophen extra-strength tablets about 12 hours prior. The patient has nausea, vomiting, malaise, and drowsiness.
 
  The patient's aspartate aminotransferase and alanine aminotransferase are mildly elevated. The primary care NP should: a. expect the patient to sustain permanent liver damage.
  b. reassure the patient that these symptoms are reversible.
  c. tell the patient that acetylcysteine cannot be given this late.
  d. administer activated charcoal to remove acetaminophen from the body.

Question 2

A patient is brought to the clinic by a spouse because of increased somnolence and disorientation. The spouse tells the primary care NP that the patient has been taking oxycodone for postoperative pain.
 
  The NP notes a respiratory rate of 8 to 10 breaths per minute. The NP should: a. activate the emergency medical service (EMS) and administer oxygen.
  b. administer oral methadone (Dolophine).
  c. administer intramuscular naltrexone (ReVia).
  d. administer sublingual buprenorphine (Subutex).

[Jayson]

Answer to Question 1

A
After acetaminophen overdose, if liver enzymes are elevated within 24 hours, irreversible liver damage is likely. Acetylcysteine may still be given to mitigate the effects. Activated charcoal is effective only when given immediately.

Answer to Question 2

C
The patient shows signs of opiate toxicity. Naltrexone is given to reverse the respiratory depression caused by opiate toxicity. The NP would activate EMS if the patient's symptoms worsen. Methadone is used to assist patients addicted to narcotics to withdraw from the drug. Buprenorphine is used to aid with withdrawal symptoms.

[Marty]

Both answers were spot on, thank you once again

[Jayson]

Great! Please up vote