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Nursing Study Guide for Lead Poisoning in Pediatrics
GeneralPreventable environmental health threat | Results in ↑ blood lead levels 5+ mcg/dL |
Risk FactorsImported candies | Paint in homes > 1978 | Dust from window sills, walls, & plaster in old homes | Certain folk remedies for GI issues (arzacon) | Soil w/ past of cars that used leaded gas | Glazed pottery & stained-glass products | Old painted toys or furniture | Lead pipes supplying water | Parent clothing w/ manufacturing job |
DiagnosticsSerum Lead Levels
- ≥ 5 mcg/dL | Serum Lead Levels
- ≥ 70 mcg/dL = hospitalization |
| | Signs & SymptomsCognitive impairments | Inattentiveness, hyperactivity, irritability
- Misdiagnosed as ADHD | Headaches | Hearing Problems | Language & speech problems | Stomach pain | ↓ bone & muscle growth | Poor muscle coordination | Seizures |
Collaborative Care & MedsChelation Therapy w/ deferoxamine | If lead > 70 mcg/dL + hospital | SQ infusion over several hrs
- At night if home | May d/c to PO deferasirox if going home {nl} - PO once daily |
| | Nursing InterventionsPerform risk assessment
- If (+) → send blood for lead levels | If lead levels > 70 mcg/dL → hospitalize & begin chelation therapy, maybe dialysis | May need early intervention program for further eval & Tx of developmental delays | Ensure lead removal of home & environment | Refer to developmental centers |
Education - Chelation TherapyEnsure adequate fluid intake | Monitor I&O closely | Dissolve PO tablet in juice or water & admin once daily |
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