Question

REVIEW MODULE CHAPTER Health Promotion and Disease Prevention Alterations in Health (Diagnosis) Pathophysiology Related to Client Problem SAFETY ASSESSMENT CONSIDERATIONS Expected Findings Risk Factors Diagnostic Procedures boratory Tests
can someone help me fill in the blanks for acetaminophen toxcity/ poisoning . please fill in all the boxes.

Answer 1

#. Diagnosis - Acetaminophen overdose

#. Pathophysiology - Intake of excessive amount of Acetaminophen during a period of hours .

When the level becomes toxic the hepatic glutathione becomes saturated (glucuronidation pathways become saturated)

70-80% saturation NAPQI begins to react with hepatocytes and injury insues

NAPQI forms protein adducts--> oxidative injury and hepatocellular centrilobar necrosis

Lipid peroxidation and mitochondrial injury by cytokines, reactive oxygen and nitrogen species

#. Risk factors :-

-excessive intake of acetominophen

-excessive Cytochrome P450 activity

-decreased capacity for glucuronidation or sulfation (Gilbert's syndrome)

-depletion of glutathione stores

-concommitant use of alcohol or other drugs (tobacco), comorbid illness, advancing age, genetic makeup, nutritional status

#. Sign and symptoms :-

Stage 1: GI symptoms (N/V, anorexia, usually a normal PE)

Stage 2: GI upset resolves, RUQ pain, elevated LFTs/INR/bili

Stage 3: Marked hepatic dysfunction (coagulopathy, LFTs peak, acidosis, hypoglycemia, jaundice, cerebral edema, coma)

Stage 4: Hepatic dysfunction resolves or death

#. Health promotion and prevention :-

- advice the patient about the proper use of Acetaminophen

- advice the patient not to take over the counter drugs

- advice the patient not to take any medication without physician order

- teach patient the side effects and complications of having medication without physician order

#. Laboratory test :-

- CBC

- LFT

- RFT

- Acetaminophen levels

- Serum amylase and lipase

- Coagulation factors

#. Diagnostic procedures include :-

- Ultrasound to assess liver enlargement

- Liver biopsy