CH 26 Flashcards
Histamine release causes which of the following effects?
- Increased recruitment of inflammatory cells
- Contraction of the smooth muscles of the respiratory system
- Increased cardiac contractility, which results in hypertension
- Activation of the kinin system
Contraction of smooth muscles of the respiratory system
An abnormal immune response that the body develops when it is re-exposed to an allergen is called:
- an allergic reaction.
- secondary response.
- anaphylaxis.
- hypersensitivity.
An allergic reaction
Transport of a patient in anaphylactic shock may be delayed for which of the following reasons?
- Epinephrine administration
- A secondary assessment
- A repeat set of vital signs
- 12-lead ECG acquisition
Epinephrine administration
Diphenhydramine (Benadryl) is used to treat allergic reactions because it:
- blocks the histamine effects at the H1 receptor sites.
- binds to H2 receptors and blocks histamine release.
- reverses the vasodilatory and bronchoconstrictive effects.
- destroys histamines and blocks their further release.
blocks the histamine effects at the H1 receptor sites.
Which of the following is a physiologic effect of histamine?
- Increased mucus secretion
- Decreased vascular permeability
- Systemic vasodilation
- Increased cardiac contractility
Systemic vasodilation
Which of the following is a common central nervous system manifestation of anaphylactic shock?
- Anxiety
- Hypertension
- Combativeness
- Vomiting
Anxiety
A 26-year-old female presents with a fever, rash, and joint pain. What should you suspect?
- Allergic reaction
- Anaphylaxis
- Lupus
- Scleroderma
Lupus
A 31-year-old man presents with diffuse hives, intense itching, and watery eyes that began acutely about an hour ago. He is conscious and alert, is breathing without difficulty, and tells you that he does not have any allergies or significant medical problems. His blood pressure is 126/76 mm Hg, pulse is 80 beats/min and strong, and respirations are 16 breaths/min and unlabored. What drug should you administer?
- Albuterol
- Epinephrine
- Oxygen
- Diphenhydramine
Diphenhydramine
Which of the following statements regarding anaphylactic shock is correct?
- In order to provide appropriate treatment, you must first determine what caused the allergic reaction.
- Most patients who carry a prescribed EpiPen are not completely aware of what substances they are allergic to.
- In the presence of anaphylaxis, intervention takes precedence over identifying the offending antigen.
- Anaphylactic shock would most likely occur following initial exposure to an offending antigen.
In the presence of anaphylaxis, intervention takes precedence over identifying the offending antigen.
Which of the following is an early clinical manifestation of an allergic reaction?
- Shock
- Hypoxemia
- Stridor
- Urticaria
Urticaria
You are caring for a 40-year-old man in anaphylactic shock after being stung by a scorpion. The patient is responsive to pain only, has poor respiratory effort, and is hypotensive and tachycardic. Which of the following represents the most appropriate treatment sequence for this patient?
- Assisted ventilation, intubation if necessary, at least one large-bore IV with normal saline, epinephrine IM or IV, and Benadryl IV or IM
- Assisted ventilation, i-gel insertion, Benadryl IM followed immediately by epinephrine SQ, and a large-bore IV with normal saline
- High-flow oxygen via nonrebreathing mask, Solu-Medrol IV, two large-bore IV lines with normal saline, and 20-mL/kg boluses of normal saline
- Immediate intubation, epinephrine SQ, two large-bore IV lines with normal saline, a 250-mL normal saline bolus, and Benadryl IM
Assisted ventilation, intubation if necessary, at least one large-bore IV with normal saline, epinephrine IM or IV, and Benadryl IV or IM
In the absence of IV or IO access, which route is the preferred route for the administration of epinephrine to a patient in anaphylactic shock?
- IM
- SQ
- ET
- Intradermal
IM
A 49-year-old male who had a heart transplant presents with a heart rate of 40 beats/min. He is weak, dizzy, lightheaded, and hypotensive. Which of the following medications would be ineffective?
- Isoproterenol
- Epinephrine
- Norepinephrine
- Atropine
Atropine
Patients with systemic scleroderma will often have symptoms of:
- Crohn disease.
- narcolepsy.
- Raynaud phenomenon.
- chronic active hepatitis.
Raynaud phenomenon
Patients with systemic lupus erythematosus:
- are routinely treated with high-dose antibiotic therapy.
- have increases in their red blood cell and platelet counts.
- often take medications that suppress their immune system.
- are typically males between the ages of 50 and 75 years.
Often take medications that suppress their immune system
