Chapter 18: Immunologic Emergencies

Question 1

Another common name for envenomation is:

Answer 1

sting

Question 2

Injection of medications such as penicillin may cause an immediate and severe reaction. “Immediate” is described as:

Answer 2

within 30 min

Question 3

Eating certain foods, such as shell fish or nuts, may result in a relatively slow reaction that still can be quite severe. That relatively slow reaction time is:

Answer 3

more than 30 min

Question 4

Which of the following is not a safe way to remove the stinger and attached muscle injected by a honeybee into the patient?

• Use clean tweezers.
• Use a clean credit card to scrape it.
• Use the edge of a sharp, stiff object to scrape it.
• Use the side of a tongue depressor to scrape it.

Answer 4

-Use clean tweezers.

Question 5

If untreated, a severe anaphylactic reaction can proceed rapidly to death. More than two-thirds of patients who die, do so within the first:

Answer 5

half hour

Question 6

Remember, the presence of hypoperfusion or respiratory distress indicates that the patient is having a severe enough allergic reaction that can lead to death. Hypoperfusion is:

Answer 6

shock

Question 7

Which of the following is not a common sign and symptom of allergic reactions in the respiratory system?

• an increase in pulse
• hoarseness
• tightness in the chest or throat
• wheezing and/or stridor

Answer 7

-an increase in pulse

Question 8

All of the following are common signs and symptoms of allergic reactions related to the circulatory system, except:

• decrease in blood pressure.
• increase in pulse rate.
• sneezing, itchy runny nose.
• loss of consciousness and coma.

Answer 8

-sneezing, itchy runny nose.

Question 9

Any substance that can trigger the body’s immune system and cause an allergic reaction is known as a(n):

Answer 9

allergen

Question 10

_______ is a harsh, high-pitched inspiratory sound.

Answer 10

stridor

Question 11

When administering an EpiPen auto injector, it is important to hold the injector in place for ________ seconds to ensure that all of the medication is injected.

Answer 11

10 sec

Question 12

Epinephrine can have an effect within:

Answer 12

1 minute

Question 13

an allergic reaction is an

Answer 13

exaggerated immune response to any substance

Question 14

an allergic reaction is not cause by

Answer 14

an outside stimulus

Question 15

an allergic reaction is caused by

Answer 15

the body’s immune system which releases chemicals to combat the stimulus

Question 16

chemicals that the body releases during the immune response

Answer 16

histamines and leukotrienes

Question 17

an allergic reaction may be ____ with hives itching and tenderness or ______ with shock and respiratory failure

Answer 17

an allergic reaction may be LOCAL/MILD with hives itching and tenderness or SYSTEMIC/SEVERE with shock and respiratory failure

Question 18

_____ is an extreme, life threatening allergic reaction

Answer 18

anaphylaxis

Question 19

2 most common signs of anapyhlaxis

Answer 19

wheezing and urticaria

Question 20

wheezing is a result of _____/_____

Answer 20

bronchospasm/bronchoconstriction

Question 21

medical term for hives

Answer 21

urticaria

Question 22

a third sign of anaphylaxis is _____ which is a result of hypovolemic shock sue to INC capillary permeability

Answer 22

HYPOTENSION

Question 23

list the five most common allergen categories

Answer 23

1. insect bites/stings
2. medications
3. food
4. plants
5. chemicals

Question 24

insects that sting repeatedly include: ____, ____, _____

Answer 24

wasps, hornets, fire ants

Question 25

death from stinging insects is ___ than deaths from snake bites

Answer 25

HIGHER

Question 26

stings can result in____ which are raised, swollen, well-defined areas on the skin

Answer 26

wheals

Question 27

the stinger should be removed by

Answer 27

scraping the skin with the edge of a sharp/stiff object

Question 28

about ___% of people have anaphylactic reactions to stings

Answer 28

5%

Question 29

signs of \_\_\_\_\_\_ to stings include:
widespread urticaria
wheals
bronchospasm and wheezing
hypotension

Answer 29

anaphylactic reactions

Question 30

allergic reactions may present as ____ or _____ in the form of shock

Answer 30

respiratory distress or cardiovascular distress

Question 31

anaphylaxis can cause rapid swelling of the

Answer 31

upper airway

Question 32

position the conscious patient in ______ and listen to lungs on each side of the chest

Answer 32

tripod position

Question 33

some patients in ____ may have hypotension

Answer 33

anaphylaxis

Question 34

_____ is needed for any patient who may be having an allergic reaction

Answer 34

prompt transport

Question 35

the secondary assessment should include a _____ or ______ to determine hidden trauma or other unrelated medical problems

Answer 35

systematic head to toe or focused assessment to determine hidden trauma or other unrelated medical problems

Question 36

in assessing the patients breathing we look for what 4 things

Answer 36

grunting
head bobbing
tripod position
nostril flaring

Question 37

vital signs will include:
____ resp. rate
____ pulse rate

Answer 37

INC resp and pulse rate

Question 38

INC pulse and hypotension =

Answer 38

ominous signs indicating systemic vascular collapse and shock

Question 39

interventions include ____ and ____ for severe reactions and ____ for milder cases

Answer 39

epi and ventilatory support for severe cases

O2 for milder cases

Question 40

epinephrine is a ____

Answer 40

sympathomimetic

Question 41

sympathomimetic means it

Answer 41

mimics the sympathetic response

Question 42

with epinephrine:
\_\_\_\_ BP
BV \_\_\_\_\_\_
broncho\_\_\_\_\_
\_\_\_ cardiac contractility

Answer 42

INC BP
BV constrict
bronchodilation
INC cardiac contractility

Question 43

adult epi dose

Answer 43

.3 mg

Question 44

pediatric epi dose

Answer 44

.15 mg