# A child with acute iron-tablet poisoning has persistent vomiting, abdominal pain, hypotension, metabolic acidosis, and a markedly elevated serum iron concentration. Which actions are appropriate? Select exactly 3 responses.

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> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A child with acute iron-tablet poisoning has persistent vomiting, abdominal pain, hypotension, metabolic acidosis, and a markedly elevated serum iron concentration. Which actions are appropriate? Select exactly 3 responses.

Select exactly 3 responses.

1

Begin therapeutic phlebotomy to remove absorbed iron from the circulation.

2

Give repeated activated-charcoal doses to bind iron in the gastrointestinal tract.

3

Monitor blood pressure because rapid IV deferoxamine can worsen hypotension.

4

Contact the poison center and prepare prescribed deferoxamine.

5

Delay chelation until a change in stool color confirms gastrointestinal iron passage.

6

Support airway, circulation, glucose, acid-base, and electrolyte status.

## Explanation

Severe acute iron poisoning requires supportive resuscitation, toxicology consultation, and chelation with carefully administered deferoxamine when indicated.

## In-depth explanation

Quick answer
Combine resuscitation and deferoxamine chelation.

Why this is correct
Deferoxamine is labeled as an adjunct to standard measures for acute iron intoxication. IV administration requires rate and blood-pressure attention, particularly in cardiovascular collapse.

Easy analogy or mental picture
Stabilize the client while the chelator gathers the circulating iron.

Memory hook
Iron poisoning: support first, chelate when indicated, watch pressure.

NCLEX decision rule
Treat the clinical severity and exposure promptly with poison-center guidance.

Why the other choices are wrong
Activated charcoal does not reliably bind iron, waiting for stool changes delays care, and phlebotomy treats a different iron-overload problem.References
1DailyMed: Deferoxamine MesylateAdjunct treatment and administration safeguards for acute iron intoxication

## Clinical scenario

Acute iron poisoning
Trend hemodynamics, acid-base status, glucose, electrolytes, serum iron, abdominal findings, and deferoxamine response.

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