UPRVUNL - 2021
Child Health Nursing (Pediatrics)
Easy
Which of the following is a treatment of choice for a child with lead poisoning?
Appeared in: UPRVUNL - 2021
Explanation
- Chelating agents are the definitive treatment for moderate to severe lead poisoning.
- These drugs bind to lead in the blood and tissues, forming a stable, non-toxic complex.
- This complex is then excreted from the body, primarily through the kidneys, which effectively lowers the body's total lead burden.
- Common agents include Succimer (DMSA), Calcium Disodium Edetate (CaNa₂EDTA), and Dimercaprol (BAL), chosen based on the severity of poisoning.
Why Other Options Were Wrong
- Option A: Gastric lavage only removes contents from the stomach and is ineffective once lead has been absorbed into the bloodstream. It does not treat systemic toxicity.
- Option B: Activated charcoal does not adsorb heavy metals like lead, iron, or lithium, making it an ineffective treatment for this type of poisoning.
- Option C: Antiemetics only provide symptomatic relief for nausea and vomiting; they do not address the root cause of the illness by removing the toxic lead from the body.
Related Visual
Clinical Relevance
- Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Pharmacological management of pediatric lead poisoning in acute care settings.
- A critical nursing responsibility during chelation therapy is ensuring the child maintains adequate hydration. This protects the kidneys from injury (nephrotoxicity) as they work to excrete the lead-chelate complex.
- Patient and family education is paramount. Nurses must teach families how to identify and eliminate sources of lead in the environment (e.g., old paint, contaminated soil, certain toys) to prevent re-exposure, which is essential for long-term recovery.
- Nurses must monitor for adverse effects of chelation, such as gastrointestinal distress, rashes, and changes in liver enzymes, and ensure follow-up blood tests are completed to track the decline in lead levels.
How to Approach the Question
- First, identify the core question: It asks for the 'treatment of choice' for a specific condition, which is lead poisoning in a child.
- This requires recalling the primary, most effective therapy, not just a supportive or situational measure.
- Evaluate each option's mechanism. Does it address the root cause (systemic lead) or just a symptom/initial ingestion?
- Analyze the distractors: 'Gastric lavage' is for recent ingestion, not absorbed poison. 'Antiemetic' treats a symptom (vomiting), not the cause. 'Activated charcoal' is known to be ineffective for heavy metals.
- Focus on the remaining option, 'Chelating agents'. Recall that chelation is the specific chemical process used to remove heavy metals from the body.
- Conclude that chelating agents are the only option that provides a definitive, systemic treatment for established lead poisoning.
Concept Tested & Keywords
- Concept Tested: Pharmacological management of pediatric lead poisoning
- Stem keywords: treatment of choice, child, lead poisoning
- Lead-in keywords: Which
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
- Negative lead-in flag: false
Question ID
QpcRu6Q2hM-oRLNm5wvVuH
Reference Book
E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 2252-2254
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 752-754
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 752-754
Practise the full UPRVUNL - 2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Poisonings, Injuries and Accidents Questions
- A 5 year old baby drank Kerosine accidentally. What is the priority management in this case?
- What safety instruction should a nurse teach a 10-year-old child with diminished sensation in the legs because of cerebral palsy?
- Most common type of injury in a 3-year-old child?
- A child is brought to the emergency department after accidentally ingesting kerosene. The child is coughing and showing signs of respiratory distress…
- In which type of poisoning should irrigation (lavage) not be given?
- Hyperbaric oxygen therapy is used to treat which of the following patients?
- Minimizing absorption of poison in a child with poisoning includes all except?
- Assuming that all have achieved normal cognitive and emotional development, which of the following children is at greatest risk for accidental poison…
- A 5-year-old child has suffered second-degree thermal burns over 30% of her body. Forty-eight hours after the burn injury; the nurse must begin to mo…
- What safety instruction should a nurse teach a 10-year-old child with diminished sensation in the legs because of cerebral palsy?
More UPRVUNL - 2021 Questions
- There is a swelling in a diffuse area. It is characterized by edema that appears at birth, disappears in several days, and crosses suture lines. This…
- The drug of choice for the treatment of manic episode is?
- The agent that causes smallpox is?
- Which of the following deficiency disease is also known as "rice eater's" disease?
- Illusion is a disorder of?
- Interstitial implantation of fertilized ovum is completed on the?
- Diaphragm is a/an?
- The bacteria that grow between 20 to 50 degrees Celsius temperature are called?
- The time period of pregnancy defined as the third trimester of pregnancy is?
- Which of the following was not discovered by Louis Pasteur?