CH 23 Allergic Reactions Flashcards
H-1). A severe or life-threatening allergic reaction in which the blood vessels dilate and the tissues lining the respiratory system swell is known as: A. tachycardia. B. anaphylaxis. C. hypotension. D. hypoxia.
B. anaphylaxis.
Anaphylaxis is a severe or life-threatening allergic reaction in which the blood vessels dilate and the tissues lining the respiratory system swell.
H-2). Which of the following would be atypical for either an allergic or an anaphylactic reaction? A. Decreased blood pressure B. Clear, unblemished skin C. Increased heart rate D. Hives
B. Clear, unblemished skin
You can get hives with a simple skin reaction or an acute anaphylactic reaction. In a non-life-threatening allergic reaction, hives tend to be localized, whereas in an anaphylactic reaction, hives tend to be generalized over wide areas of the body. Unblemished skin would be atypical for either an allergic or an anaphylactic reaction. Hypotension and tachycardia are both associated with anaphylaxis.
H-3). Which of the following is a sign of an anaphylactic reaction but not of a non-life-threatening allergic reaction? A. Stridor B. Cough C. Sneezing D. Wheezing
A. Stridor
*** NOTE: The KEY here is “NOT of a NON-LIFE THREATENING ALLERGIC REACTION” meaning that it IS indicative of a LIFE THREATENING ALLERGIC REACTION
H-4). A patient with anaphylaxis must have either respiratory distress or: A. sneezing, cough, or mild dyspnea. B. local swelling. C. signs and symptoms of shock. D. a history of allergies.
C. signs and symptoms of shock.
To be considered a severe allergic reaction, or anaphylaxis, the patient must have either respiratory distress or signs and symptoms of shock.
H-5). Which of the following assessment findings is most likely to indicate a severe allergic reaction? A. Local swelling B. Wheezing C. Local hives D. Hypotension
D. Hypotension
Although all these findings indicate an allergic reaction, only hypotension indicates a severe reaction.
H-6). What does the immune system use to fight off invasion by foreign substances in the body? A. Capillaries B. Allergens C. Mucus D. Antibodies
D. Antibodies
The first time someone is exposed to an allergen, the immune system forms antibodies in response. These antibodies are the body’s attempt to attack the foreign substances.
H-7). The second time that a person is exposed to an allergen, the antibodies formed in response to that allergen: A. cease to be effective. B. must be reformed. C. revert to an inactive state. D. already exist in the person's body.
D. already exist in the person’s body.
H-8). A 44-year-old female has anaphylaxis after being injected with a new antibiotic. The patient has stridor. This finding is most likely due to: A. swelling around the vocal cords. B. pulmonary edema. C. bronchoconstriction. D. hypovolemia.
A. swelling around the vocal cords.
Swelling in the upper airway, such as around the vocal cords, is the most likely cause of stridor. Pulmonary edema typically causes rales. Bronchoconstriction causes wheezing.
H-9). The release of histamine and other chemicals during an allergic reaction does what to thick mucus in the lungs? A. Loosens it B. Promotes its production C. Depletes it D. Thins it
B. Promotes its production
The release of histamine and other chemicals during an allergic reaction promotes the production of thick mucus in the lungs.
H-10). Bees, yellowjackets, wasps, and hornets cause allergic reactions with: A. pollen. B. any contact. C. their stings. D. their bites.
C. their stings.
Bees, yellowjackets, wasps, and hornets can cause rapid anaphylaxis by stinging. Biting and non-flying insects can cause anaphylaxis, but not as commonly as bees, yellowjackets, wasps, and hornets.
H-11). What typically distinguishes a peanut allergy from other food allergies? A. Linked to many other allergies B. Slower effect C. Lesser severity D. Rapid onset
D. Rapid onset
In most cases, the effect of a food allergy is slower than that seen with insect stings. An exception is peanuts. Peanut allergies are frequently very severe and very rapid in onset. Many people with allergies to one food will have allergies to related foods (e.g., someone who is allergic to almonds is more likely to be allergic to walnuts). Again, peanuts are an exception. People who are allergic to peanuts do not necessarily have any other allergies, including to nuts (in part because peanuts are legumes, not nuts).
** Important to note: A patient with this allergy does NOT have a “nut allergy.” They have a PEANUT allergy. So, this is what differentiates their allergy from the legume family and the nut family. People want to know WHY someone has a nut allergy if someone is allergic to peanuts. That is the reason why.
H-12). Which of the following statements about epinephrine is true?
A. Epinephrine is a hormone produced by the body.
B. Epinephrine will slow the heart rate.
C. EMTs are not trained to use the epinephrine auto-injector.
D. Epinephrine is indicated for moderate allergic reactions.
A. Epinephrine is a hormone produced by the body
– It is also called adrenaline
H-13). A 7-year-old male patient was stung by a bee while playing outside. He is crying and being held by his mother. Which of the following signs would indicate a need to administer epinephrine to this patient? A. Stridor B. Local hives C. Coughing D. Mild anxiety
A. Stridor
Although all these findings indicate an allergic reaction, only stridor would indicate anaphylaxis and therefore require epinephrine.
***NOTE: It is indicative of anaphylaxis, not necessarily,
H-14). Asking a patient experiencing an allergic reaction about how the patient was exposed to the allergen involved typically happens during: A. taking baseline vital signs. B. secondary assessment. C. reassessment. D. primary assessment.
B. secondary assessment.
H-15). Completing the remainder of the past medical history for a patient with an allergic reaction typically happens:
A. before determining to which allergen the patient was exposed.
B. after reassessing the patient following administration of epinephrine.
C. before care for life-threatening problems.
D. after inquiring about what interventions may have already been provided.
D. after inquiring about what interventions may have already been provided
Completing the remainder of the past medical history for a patient with an allergic reaction typically happens after inquiring about what interventions may have already been provided but before providing any patient care such as administering epinephrine.
H-16). What is an exception to the rule that EMTs may only administer epinephrine for patients with a prescription?
A. The patient signs a permission form.
B. The region allows EMTs to carry and administer epinephrine.
C. It is impossible to contact medical direction for authorization.
D. The patient is in anaphylactic shock.
B. The region allows EMTs to carry and administer epinephrine.
In some areas, EMTs carry and administer epinephrine. If this is the case, a prescription for epinephrine is not necessary.
H-17). A patient with anaphylaxis is carrying a prescribed EpiPen. The EMT in this case:
A. must contact medical control for authorization before assisting the patient with administration of the epinephrine.
B. may freely assist the patient with administration of the epinephrine but may not personally administer it.
C. may freely administer epinephrine to the patient.
D. must observe the patient’s actions with the EpiPen but not assist or otherwise intervene.
A. must contact medical control for authorization before assisting the patient with administration of the epinephrine.
If a patient with anaphylaxis is carrying a prescribed EpiPen, the EMT must still contact medical control for authorization before assisting the patient with administration of the epinephrine.
H-18). A 15-year-old male has hives and GI distress after ingesting eggs. Medical control has ordered administration of an epinephrine auto-injector: Which of the following findings would be an expected side effect of this drug? A. Nausea B. Muscle cramps C. Excessive hunger D. Drowsiness
A. Nausea
Nausea is a common side effect of epinephrine administration. Patients do not commonly become drowsy; they typically become agitated. Cramping is possible, but it is not as common as nausea.
H-19). What is not a side effect of epinephrine administration? A. Nausea and vomiting B. Dilation of the bronchioles C. Increased heart rate D. Excitability and anxiety
B. Dilation of the bronchioles
Dilation of the bronchioles is one of the expected actions of epinephrine administration. The other effects are side effects.
H-20). The recommended single dosage of epinephrine for an infant or child with a severe allergic reaction is how many milligrams? A. 0.15 mg B. 0.30 mg C. 0.03 mg D. 1.50 mg
A. 0.15 mg
This is half of the adult dose which is .30 (.3)
H-21). Your patient is suffering from severe anaphylactic shock. After obtaining the patient’s epinephrine auto-injector and ensuring that it is prescribed to your patient, you should:
A. remove the cap from the device.
B. ensure that you have appropriate medical direction to administer the medication.
C. place the tip of the device against the patient’s thigh.
D. have a friend or family member administer the epinephrine into the outer region of the patient’s thigh.
B. ensure that you have appropriate medical direction to administer the medication.
The EMT must have authorization and follow all protocols for any given intervention. In this situation, the EMT may have to contact medical control before administration of the EpiPen.
H-22). Which of the following is the most reliable indication of improvement in a patient with anaphylaxis who was treated with an epinephrine auto-injector? A. Improvement of breathing difficulty B. Increased sweating C. Persistent tachycardia D. Decrease in blood pressure
A. Improvement of breathing difficulty
Epinephrine will cause bronchodilation, which will improve the ease of breathing. Tachycardia is a common side effect but can also be present without improvement. Epinephrine typically raises blood pressure.
H-23) Which of the following actions is no longer necessary if reassessment after treatment of anaphylaxis has demonstrated improvement?
A. Additional dosages of epinephrine
B. Treatment for shock
C. Administration of oxygen
D. Monitoring of vital signs, including lung sounds
A. Additional dosages of epinephrine
PT-1). What are produced by the body to attack foreign substances? A. Allergens B. Antibodies C. Platelets D. Antigens
B. Antibodies
PT-2). Histamine release increases vascular permeability. What physical sign is associated with this pathophysiology? A. Flushed skin B. Decreased cardiac output C. Urticaria D. Swelling
D. Swelling
PT-3). Which of the following is an anticipated side effect of epinephrine administration? A. Tachycardia B. Vasodilation C. Lethargy D. Hypotension
A. Tachycardia
PT-4). What finding is least likely to make an EMT suspect an allergic reaction?
A. The patient complains of itching, hives, or difficulty breathing.
B. The patient has come into contact with an allergen that has caused an allergic reaction in the past.
C. The patient has dry eyes and nose.
D. The patient shows signs or symptoms of shock.
C. The patient has dry eyes and nose.
PT-5). What finding most clearly indicates anaphylaxis? A. Mild dyspnea B. Generalized pallor C. Local swelling D. Local hives
B. Generalized pallor
PT-6). A 35-year-old male is suffering a severe anaphylactic reaction. You have administered one of the patient’s two epinephrine auto-injectors as indicated; however, after 10 minutes, the patient’s condition has not improved. You should next:
A. wait 10 more minutes and then administer the second auto-injector.
B. inject the second auto-injector, but this time try to inject it into a vein.
C. consult with medical control and administer the second auto-injector.
D. not administer the second auto-injector, because two consecutive doses of epinephrine are never indicated. The second one is simply a spare.
C. consult with medical control and administer the second auto-injector.
PT-7). Which of the following statements about poison ivy is true?
A. Poison ivy must enter the system through broken skin.
B. It is the oil on the leaves of the poison ivy plant that causes the allergic reaction.
C. Only about 10% of the population is allergic to poison ivy.
D. Poison ivy is a common cause of weeping sores on the skin.
B. It is the oil on the leaves of the poison ivy plant that causes the allergic reaction.
PT-8). In an allergic reaction when an antibody combines with the allergen, what substance is released that causes bronchoconstriction, promotion of thick mucus production in the lungs, vasodilation, and increased vascular permeability? A. Basophils B. Adrenaline C. Histamine D. Plasma
C. Histamine
PT-9). A 17-year-old male presents with itchy skin after exposure to peanuts. He is allergic to peanuts. The findings at this point indicate: A. an anxiety attack. B. a skin infection. C. an anaphylactic reaction. D. an allergic reaction.
D. an allergic reaction.
PT-10) If a patient reports an allergy to walnuts, what other food should the patient probably avoid? A. Strawberries B. Chocolate C. Almonds D. Crayfish
C. Almonds
PT-11) Which of the following would best describe a situation where a patient was experiencing shock and respiratory compromise after exposure to a known allergen? A. Moderate allergic reaction B. Mild allergic reaction C. Anaphylaxis D. Local allergic reaction
C. Anaphylaxis
PT-12). In your management of a patient with true anaphylaxis who has a prescribed epinephrine auto-injector, which of the following interventions is most correct?
A. Contact medical direction for authorization to administer the epinephrine auto-injector.
B. Wait for ALS to arrive before giving any medications, including epinephrine.
C. Place the patient on oxygen at 6 lpm via nasal cannula.
D. If the patient is unconscious, place the patient upright in a position of comfort to assist with the patient’s breathing difficulty.
A. Contact medical direction for authorization to administer the epinephrine auto-injector.
