Chapter 20

Question 1

allergy related emergencies may involve:
acute…
… collapse

Answer 1

airway obstruction

cardiovascular

Question 2

an … is an exaggerated immune response to any substance
not caused directly by an outside stimulus
caused by the body’s ..–> releases chemicals to combat the stimulus

Answer 2

allergic reaction; immune system

Question 3

allergic rxns may be … and …, characterized by itching, redness, and tenderness or … and …–a condition known as anaphylaxis

Answer 3

mild; local; severe; systemic

Question 4

anaphylaxis is an extreme, life threatening allergic rxn: involves multiple …
can rapidly result in … and …

Answer 4

organ system; shock; death

Question 5

three common signs of anaphylaxis:
… (hives)
..
…

Answer 5

urticaria;
angioedema
wheezing

Question 6

in anaphylaxis, patients may also experience:
… due to vasodilation and increased …
gastrointestinal dysfunction (e.g. nausea, vomiting, and abdominal cramps)

Answer 6

hypotension; capillary permeability

Question 7

common allergens:
..–> symptoms may take more than 30 mins to appear
…–> if injected, rxn may be immediate and severe; rxns to oral ones may take more than 30 mins to appear

Answer 7

food; medicine

Question 8

common allergens cont:

plants: .., …, and other plant materials
chemicals: .., .., and…–> … is of particular concern to health care providers

Answer 8

dusts; pollens; makeup; soap; hair dye; latex

Question 9

insect bites and stings:
…: the process of an insect injecting its venom
the reaction may be localized or systemic

Answer 9

envenomation

Question 10

approx. 3% of adults and 1% of children are allergic to venom of bees, wasps, and hornets
insect stings cause at least 50 deaths/yr in the US
the stinging organ of most insects is a small, hollow … projecting from the ..

Answer 10

spine; abdomen

Question 11

signs and symptoms for insect stings: 
sudden ..
…
localized …
… 
… in light skinned people 
… and a … (raised, swollen, well-defined area on skin)
as long as these remain localized, they're usually not serious

Answer 11

pain
swelling
heat
urticaria
redness
itching; wheal

Question 12

in severe cases of insect stings, patients may experience: 
… and …
… and …
… 
.. 
… complaints 
…

Answer 12

bronchospasm; wheezing
chest tightness; coughing
dyspnea
anxiety
gastrointestinal
hypotension

Question 13

for insect stings patients may occasionally experience …; if untreated, an anaphylactic rxn can proceed rapidly to death–> more than 2/3 of patients who die of anaphylaxis do so within the first … mins

Answer 13

resp failure; 30

Question 14

gen impression:

allergic rxns may present as … or … distress in the form of …

Answer 14

resp/cardio; shock

Question 15

anaphylaxis can cause rapid swelling of the ..

Answer 15

upper airway

Question 16

airway and breathing--> 
quickly assess for: 
increased …
use of … 
…
… positioning
…
abnormal ..

Answer 16

work of breathing; 
accessory muscles
head bobbing
tripod
nostril flaring
breath sounds

Question 17

if isgns of shock emerge, place the patient in the … position

Answer 17

supine

Question 18

circulation: some patients in anaphylaxis may present with …
assess for signs of hypoperfusion
treat for …
definitive treatment is …

Answer 18

hypotension; shock; epinephrine

Question 19

for history taking be alert for any statements regarding … that might cause allergic rxns and ask about … complaints (nausea/vomiting)

Answer 19

ingestion of foods; gastrointestinal

Question 20

secondary physical exam:
remove clothing to look for presence of…, signs of contact with .., and other clues suggestive of a rxn
skin signs may be unreliable indicators of .., as they may vary widely or be hidden by rashes/swelling

Answer 20

bee stingers; chemicals; hypoperfusion

Question 21

interventions:
determine severity of rxn
mild reactions require … and …
anaphylaxis requires .. and ….

Answer 21

supportive care; monitoring; epinephrine; ventilatory support

Question 22

if stinger is present, … the skin with the edge of a sharp, stiff object like a credit card
do not use … or …

Answer 22

scrape; tweezers; forceps

Question 23

epinephrine:
mimics the .. response
rapidly reverses effects of anaphylaxis
… and comes pre-doesed in an injector

Answer 23

sympathetic; prescribed

Question 24

the adult EpiPen delivers .. mg of epinephrine
infant-child system delivers … mg
epi can have an effect within .. mins

Answer 24

0.3; 0.15; 1

Question 25

side effects of epi: 
… blood pressure
… pulse rate
…
cardiac …
… 
.. 
… 
… 
.. 
...

Answer 25

high; 
increased
anxiety
arrhythmias
pallor
dizziness
chest pain
headache
nausea
vomiting

Question 26

don’t give epi to patients without signs of … or … and patients who don’t meet criteria for …

Answer 26

resp compromise; hypotension; anaphylaxis