The study aimed to determine the effect of implementing nursing guidelines among patients' with lead poisoning on their health outcomes. It was conducted in internal medicine department and outpatient clinic at Qena university hospital. Convenience samples comprised of 60 adult patients from both sex and were confirmed with lead poisoning. Two instruments were used in this study. Tool 1: Patients' knowledge regarding lead poisoning and their complain questionnaire (tool 1- part I, II ) and attached to socio-demographic data. Tool 2: Nutritional Profile among lead poisoning patients and clinical base data of laboratory investigations observational Checklist to confirm the diagnosis with lead poisoning (tool 2 part I, II ). It was taken one time before implementing the nursing guidelines, and three times, once every 5 days to monitor the difference rates in these parameters to evaluate the effect of suggested nursing guidelines and therapeutic regimen (tool 3) on lead poisoning patient's outcomes ( tool1, and tool 2). Result: The study findings revealed that mean ages was 44.93 + 11.77. In pretest, 78.33 % of them had 11-13 mcg/dL serum lead, after implementation of nursing guidelines decreased to16.67% of them , Also, there was statistically significant difference (P = 0.001) in laboratory findings (P value 0.005). Concerning GIT 100% of pretest they had abdominal pain, anorexia, and constipation by the 3rd week decreased to zero ((P value 0.005). As regard neurological assessment short concentration, depression, and fatigue were statistically significant difference (P = 0.005) respectively. Conclusions: There was statistically significant improvement after implementation of nursing guidelines in their lab. investigations levels, systemic manifestations and their knowledge when compared the posttest with pre assessment. Recommendations: additional successful clinical evidence is required with validated laboratory findings to establish effective alternative medicines for treating lead poisoning