RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022
Medical & Surgical Nursing
Medium
As an Emergency Department nurse, a patient admitted with bleach poisoning should be prevented from
Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022
Explanation
- Bleach is a corrosive (caustic) substance that causes severe chemical burns to the mucous membranes of the gastrointestinal tract.
- Inducing vomiting is absolutely contraindicated because it re-exposes the esophagus, pharynx, and mouth to the corrosive agent, causing a second, often more severe, burn.
- Vomiting also carries a high risk of aspiration, where the corrosive chemical enters the lungs, leading to life-threatening chemical pneumonitis.
- Therefore, preventing vomiting and aspiration is a top priority in managing a patient with corrosive poisoning.
Why Other Options Were Wrong
- Option B: Gastric lavage is also a contraindicated procedure in corrosive poisoning. However, preventing the physiological event of vomiting and its direct consequence, aspiration, is the more immediate and primary patient management goal.
- Option C: This is an intervention that is often recommended, not prevented. Giving small amounts of water or milk can help dilute the corrosive substance, reducing its concentration and limiting further damage.
- Option D: Sample collection (e.g., blood, urine) is a crucial part of the diagnostic workup. It helps in assessing the patient's overall condition, monitoring organ function, and guiding treatment. It should not be prevented.
Related Visual
Clinical Relevance
- Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Management of Corrosive Poisoning in acute care settings.
- The primary rule in corrosive ingestion is to protect the airway and avoid any action that could cause re-exposure of the esophagus or aspiration. This is a critical patient safety principle.
- Nurses must be prepared for rapid airway deterioration due to laryngeal edema and have resuscitation equipment, including a difficult airway cart, readily available.
- What if the patient had ingested a large amount of a non-corrosive substance like paracetamol (acetaminophen)? In that case, gastric lavage (if within 1 hour) or, more commonly, administration of activated charcoal would be a primary intervention to prevent absorption, which is the opposite of the management for corrosives.
How to Approach the Question
- First, identify the substance ingested. The question specifies 'bleach,' which is a known corrosive (caustic) agent.
- Next, recall the specific principles for managing corrosive poisoning. The main goal is to limit further tissue damage.
- Analyze the keyword in the question stem: 'prevented'. This directs you to identify a contraindicated action or a complication that must be avoided.
- Evaluate each option against the principles of corrosive poisoning management. Both inducing vomiting and performing gastric lavage are contraindicated.
- Prioritize the options. Preventing the physiological event of vomiting and its life-threatening complication of aspiration is the most immediate and critical nursing priority for patient safety, making it the best answer.
Concept Tested & Keywords
- Concept Tested: Management of Corrosive Poisoning
- Stem keywords: Emergency Department, bleach poisoning, prevented
- Lead-in keywords: should be prevented from
- Clinical cues: The care setting changes urgency, monitoring level, and the expected nursing action.
- Negative lead-in flag: false
Question ID
QPTZxhEnUqfdRM5-R2jyrl
Reference Book
E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 129-131
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 752-754
E6 Medicine Davidson Principles Practice 24e p. 167-169
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