The maximum recommended dose for acetaminophen is 4 g/day. The client ingested 9 g as a one-time dose, which is sufficient to induce liver impairment. The priority action is to remove as much of the medication from the stomach as possible. The second action would be activated charcoal. IV fluids will not affect the metabolism of acetaminophen by the liver yet may be used to maintain hydration. Acetylcysteine is effective in third-stage liver injury; given the time interval of ingestion, it would be premature to administer this pharmaceutical.
