In acetaminophen overdose management, if an N-acetylcysteine oral dose is vomited within 1 hour of administration, what should the nurse do?

• A. Repeat that oral dose
• B. Withhold the dose
• C. Give the next scheduled dose
• D. Switch to IV administration

Answer: (A)

When treating acetaminophen overdose with N-acetylcysteine given by mouth, it's crucial that the antidote is absorbed to replenish glutathione and detoxify the toxic metabolite. If the patient vomits within an hour of taking an oral NAC dose, the dose may not have been absorbed, so the safest and most effective action is to repeat that dose right away. This ensures the patient receives the full intended amount and maintains therapeutic NAC levels to continue protecting the liver. If vomiting continues and oral administration cannot be tolerated, switch to IV NAC according to protocol.