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Nursing Study Guide for Lead Poisoning in Pediatrics
General
Preventable environmental health threat |
Results in ↑ blood lead levels 5+ mcg/dL |
Risk Factors
Imported 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 |
Diagnostics
Serum Lead Levels
- ≥ 5 mcg/dL |
Serum Lead Levels
- ≥ 70 mcg/dL = hospitalization |
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Signs & Symptoms
Cognitive impairments |
Inattentiveness, hyperactivity, irritability
- Misdiagnosed as ADHD |
Headaches |
Hearing Problems |
Language & speech problems |
Stomach pain |
↓ bone & muscle growth |
Poor muscle coordination |
Seizures |
Collaborative Care & Meds
Chelation 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 |
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Nursing Interventions
Perform 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 Therapy
Ensure adequate fluid intake |
Monitor I&O closely |
Dissolve PO tablet in juice or water & admin once daily |
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