The primary concern with acetaminophen poisoning is the use of intravenous fluids, anti-nausea
medicine, activated charcoal administration through ryles tube if utilized within one hour of
consumption, and antidotal treatment, including N-acetylcysteine.
In general, the nurse's assessment comprises taking a history and gathering data on the number of
tablets consumed and the time spent.
The nurse should look for signs and symptoms of acetaminophen toxicity, such as yellowing of
the skin and eyes, black urine and stool, anorexia, nausea, vomiting, and discomfort in the right
upper quadrant of the abdomen. Renal failure and pancreatitis can develop without liver failure
in some cases. The nurse should undertake confirmatory acetaminophen toxicity testing, which
includes serum acetaminophen levels, electrolytes, renal function tests, amylase, lipase, liver
function tests, complete blood count, and coagulation factors. The Nomogram of Rumack and
Matthew— This is a test for seeing how much of an impact it has on the liver. The test compares
acetaminophen levels in the blood to the time since the medicine was consumed.
Nursing Intervention:
Informed consent is a legal document that describes the tests, treatments, or procedures that may
be required. Continuous monitoring of vital signs to keep them normal and rule out any
alterations. If there is a decline in oxygen saturation, provide oxygen as directed by a physician.
Activated charcoal can aid in the absorption of acetaminophen in the gastrointestinal system. It is
administered orally. Gastric lavage is also performed to clear the stomach. The acetaminophen
will be removed from your stomach by the healthcare provider. In most situations of toxic
acetaminophen overdose, N-acetylcysteine, an amino acid, is administered orally or
intravenously (via a vein) as an antidote.
2.
Activated charcoal can prevent acetaminophen absorption in the stomach within 1-2 hours of
exposure. It works by attaching to pharmaceutical medications or poisons, such as
organophosphates, and limiting hazardous agent absorption in the body.
N-Acetylcysteine is a glutathione precursor. It promotes the sulfate conjugation of unmetabolized
APAP, acts as an anti-inflammatory and antioxidant, and has inotropic properties. It boosts local
nitric oxide concentrations and enhances microcirculatory blood flow, resulting in improved
local oxygen supply to peripheral tissues.
Cimetidine is used to reduce the effects of acetaminophen.
Anti-emetics to help with n/v 0.9 percent NS hydration from fluid loss owing to nausea
Antidotes to prevent the creation of, or to detoxify, metabolites include blocking paracetamol
absorption from the gastrointestinal tract (decontamination), removing paracetamol from the
circulatory system, and antidotes to prevent or detoxify metabolites.
