A child is brought to the emergency department because he ingested an unknown quantity of acetaminophen (Tylenol). What does the nurse expect this child to receive following gastric lavage?

Choice A reason: Syrup of ipecac is obsolete for acetaminophen overdose, as it delays definitive treatment like N-acetylcysteine. Acetaminophen causes hepatotoxicity via toxic metabolites, requiring specific antidote administration. Ipecac risks aspiration and is ineffective post-gastric lavage, making it an inappropriate choice for managing this potentially life-threatening overdose. Choice B reason: Vitamin K treats bleeding from anticoagulant overdose, not acetaminophen toxicity, which causes hepatotoxicity by depleting glutathione, leading to liver damage. Vitamin K does not address acetaminophen’s metabolic effects, making it irrelevant. N-acetylcysteine is needed to restore glutathione and detoxify metabolites, making this choice incorrect. Choice C reason: N-acetylcysteine is the antidote for acetaminophen overdose, replenishing glutathione to detoxify the toxic metabolite NAPQI, preventing liver damage. Administered post-gastric lavage, it reduces hepatotoxicity risk, especially if given within 8 hours of ingestion, making it the expected treatment to protect the child’s liver function. Choice D reason: Activated charcoal adsorbs toxins in the gut but is less effective post-gastric lavage, as the stomach is already cleared. Acetaminophen’s rapid absorption requires N-acetylcysteine to prevent hepatotoxicity. Charcoal may be used early but is secondary to the antidote, making it less critical in this scenario.