A nurse in an emergency department is caring for a preschool-age child who has acute acetylsalicylic acid poisoning. Which of the following should the nurse expect?

Acute acetylsalicylic acid (aspirin) poisoning in children is a serious toxicologic emergency that affects multiple body systems. It commonly results in metabolic acidosis, respiratory alkalosis, and disruption of thermoregulation due to uncoupling of oxidative phosphorylation. Pediatric patients are especially vulnerable to rapid deterioration, including neurologic changes, acid-base imbalance, and altered temperature regulation. Recognizing key clinical manifestations such as abnormal body temperature is essential for early intervention. Rationale: A. Hyperpyrexia is expected in aspirin poisoning because salicylates uncouple oxidative phosphorylation, leading to increased metabolic activity and excessive heat production. This disrupts the body’s ability to regulate temperature, resulting in dangerously elevated body temperature. Hyperthermia is a hallmark sign of moderate to severe salicylate toxicity in children. B. Neck vein distention is not associated with aspirin toxicity. It is more commonly seen in conditions involving fluid overload or cardiac dysfunction, such as heart failure or cardiac tamponade. Salicylate poisoning primarily affects metabolic and respiratory systems rather than causing venous congestion. C. Jaundice is not a typical manifestation of acute aspirin poisoning. While severe overdose may eventually affect liver function, jaundice is more commonly associated with hepatic diseases or hemolytic conditions rather than early salicylate toxicity. The primary effects are metabolic and neurologic rather than hepatic in presentation. D. Polyuria is not a characteristic finding in acute acetylsalicylic acid poisoning. Although fluid and electrolyte disturbances can occur, aspirin toxicity does not typically present with increased urine output as a primary symptom. Instead, early signs include hyperventilation, tinnitus, fever, and metabolic disturbances.