The next day you are again assigned to care for a. b. at the beginning of the shift, you assess a. b. and find that his condition is stable. his lung sounds remain diminished in the right lower lobe and his spo2 is 95% on oxygen at 2 l per nasal cannula. the chest drainage system is attached to suction at 20 mm hg; there is still an air leak present. his morning chest x-ray examination showed some residual pleural effusion. four hours into your shift, he pages you through the call system and tells you he feels “short of breath.” you immediately go to his room. a. b. is sitting in the chair. describe the priority assessment you must perform at this time. assess respiratory function—respiration rate, breath sounds, o2 saturation, drainage system

The parents of a 9-year-old girl bring their daughter to the ed. for the last 12 hours, the child has suffered severe nausea and vomiting, as well as diarrhoea and abdominal cramps. further discussion with the child indicates that she suffers from blurred vision and headache. the parents originally were worried about bringing the child to the ed because they feared deportation since the family are illegal immigrants employed to pick strawberries on a nearby farm. on direct questionning, the parents admit that the child was assisting with spraying crops with pesticides the previous day. none of the family members was wearing any protecting clothing. her bp is 88/48 mmhg, pulse is 90/min, rr 33/min, temp 38 c. the child appears sweaty and confused. auscultation of the lungs reveals a diffuse wheeze bilaterally. pupils are miotic and the child has diffuse muscle weakness. which of the following interventions is the most appropriate treatment? - atropine- charcoal- glucagon- naloxone- exposure: consider organophosphate poisoning, which inhibits cholinesterase and results in accumulation of ach in both muscarinic and nicotinic sites. pralidoxime activates achatropine competes with ach only at muscarinic receptors, but will not reverse nicotinic effectscharcoal = gastric decontaminationglucagon = reverse beta-blocker overdosenaloxone = reverse effects of opioids