Anaphylaxis

You’re providing care to a patient in anaphylactic shock. What is NOT a typical medical treatment for this condition, and if ordered the nurse should ask for an order clarification?

• Type I Hypersensitivity Reaction

• Type II Hypersensitivity Reaction

• Type III Hypersensitivity Reaction

• Type IV Hypersensitivity Reaction

Anaphylactic shock can occur due to either an immunological or non-immunological cause. Select ALL the CORRECT statements about the differences between an immunological reaction (anaphylactic) and non-immunological reaction (anaphylactoid):

• In an immunological reaction (anaphylactic) IgE antibodies are created and they attach to mast cells and basophils.

• An immunological reaction (anaphylactic) requires a patient to be sensitized for anaphylactic shock to occur.

• A non-immunological reaction (anaphylactoid) causes the same reaction as an anaphylactic reaction, but it’s not due to immunoglobulin IgE antibodies.

• Some common substances that cause a non-immunological reaction (anaphylactoid) are IV contrast  dyes and NSAIDS.

• A patient does not have to be sensitized for a non-immunological reaction (anaphylactoid) to occur and it can happen with first time exposure.

During anaphylactic shock the mast cells and basophils release large amounts of histamine. What effects does histamine have on the body during anaphylactic shock? Select all that apply:

• Decreases capillary permeability

• Vasodilation of vessles

• Decreases heart rate

• Shifts intravascular fluid to interstitial space

• Constricts the airways

A patient is in anaphylactic shock. The patient has a severe allergy to peanuts and mistakenly consumed stir fry cooked in peanut oil during his lunch break. The patient is given Epinephrine IM. As the nurse, you know this medication will have what effect on the body?

• It will prevent a recurrent attack.

• It will cause vasoconstriction and decrease the blood pressure.

• It will help dilate the airways.

• It will help block the effects of histamine in the body.

You're providing care to a patient in anaphylactic shock. What is NOT a typical medical treatment for this condition, and if ordered the nurse should ask for an order clarification?

• IV diphenhydramine

• Epinephrine

• Corticosteroids

• Isotonic intravenous fluids

• IV furosemide

You're using an EpiPen trainer to teach a patient how to use their Epipen. What actions show that the patient requires more teaching? Select all that apply.

• The patient injects the medication in the subcutaneous tissue of the abdomen.

• The patient massages the site after injection.

• The patient administers the injection through their clothes.

• The patient aspirates before injecting the medication.

A patient is having an anaphylactic reaction to a new medication. What is the first action the nurse should take?

• Administer epinephrine

• Call a rapid response

• Stop the medication

• Administer oxygen

What is the best position for a patient in anaphylactic shock?

• Lateral recumbent

• Supine with legs elevated

• High Fowler's

• Semi-Fowler's