A 5-year-old boy presents with recent ingestion of an entire bottle of chewable pediatric acetaminophen. The child’s mother learned of the ingestion two hours after it occurred and immediately brought the child to the closest emergency department an hour away. The patient weighs 41 pounds. Which of the following prescriptions should the nurse most likely anticipate initially?

Question

A 5-year-old boy presents with recent ingestion of an entire bottle of chewable pediatric acetaminophen. The child&rsquo;s mother learned of the ingestion two hours after it occurred and immediately brought the child to the closest emergency department an hour away. The patient weighs 41 pounds.  Which of the following prescriptions should the nurse most likely anticipate initially?

Accepted Answer

Acetylcysteine 150 mg/kg intravenously over 1 hour. For patients less than 20 kg who presents with an acetaminophen overdose less than 10 hours prior to the initiation of treatment, a continuous infusion of acetylcysteine is used. The patient receives a loading dose of 150 mg/kg diluted in 3ml/kg of a diluent over 1 hour; this is followed by 50 mg/kg in 7ml/kg diluent over 4 hours. Oral administration of acetylcysteine is less ideal than intravenous administration. Acetylcysteine 70 mg/kg IV q4h is indicated for maintenance dosing of acetylcysteine when treatment is started more than 10 hours after ingestion of acetaminophen. Acetylcysteine 100 mg/kg IV over 16 hours is the third of three doses, not the initial dose.

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