CHP 26: IMMUNOLOGIC EMERGENCIES Flashcards
what is the protein the body produces in response to an antigen
antibody
what is the primary antibody responsible for allergic reactions
IgE
what is a biphasic allergic reaction
pt’s symptoms improve and then reappear up to 8 or more hours after incident
what is prolonged allergic reaction
continue over 5-32 hours
what is an anaphylactoid reaction
response that does not involve IgE antibody mediation
which allergy is a contraindication to receiving flu vaccine
eggs
what are atopic diseases
diseases related to allergies
three categories of allergic reactions
mild: localized and do not spread
moderate: start mild but spread to other parts of body
severe: anaphylactic, systemic
what does “shark fin” capno waveform indicate
bronchoconstriction
what lung sounds indicate upper airway swelling
stridor
what does histamine release cause
vasodilation and decreases inotropic effects of heart
what is angioedema
swelling of face and tongue
3 types of shock during anaphylaxis and their causes
cardiogenic: decreased cardiac output
hypovolemic: fluids leaking into tissues
neurogenic: inability of blood vessels to constrict
what can cause red man syndrome
vancomycin infusions
what kind of food poisoning can mimic anaphylactic reactions
scombroid fish poisoning
drug of choice for patients with signs of allergic reaction like urticaria but no respiratory distress
diphenhydramine
what positioning is associated with increased mortality rate in anaphylactic patients
upright
how does administering epinephrine effect the body during anaphylaxis
blood vessel constriction, elevates diastolic BP, increases cardiac contractility, improves inotropy, bronchodilation
how much fluids to administer to pt with anaphylactic hypotension
20mL/kg over 15mins
what type of diseases are collagen vascular diseases
autoimmune
what is lupus
chronic, progressive, multisystem autoimmune disease
inflammation, loss of tissue integrity, permanent damage
pt has flares of symptoms in beginning stages
usually ends in kidney failure, infection, or cardiovascular disease
S/S of lupus
rash aggravated by sunlight, joint/muscle aches, pleural issues, pericarditis or AMI, stroke, seizures, renal failure, electrolyte imbalance, UTI, anemia, bloody stools, abdominal cramping
what is scleroderma and its two types
autoimmune connective tissue disease that hardens the skin
localized: is on skin or muscles without spreading
systemic: fibrosis to body, blood vessels, joints, and organs
S/S of scleroderma
Raynaud phenomenon, aches and pains, decreased joint motion, stiffness of lungs and SOB, dysrhythmias, decreased blood flow to kidneys
what is Raynaud phenomenon
pain, blanching, cyanosis, or redness of fingers and toes when stress occurs or when exposed to cold or stress
how does transplant heart act different from normal heart
vagus nerve denervation - can’t generate anginalike pain so pt with ischemia will present with heart failure symptoms or dysrhythmias instead of angina
what medication will transplant heart not respond to
atropine
S/S of kidney transplant rejection
fever, tenderness and swelling over implanted kidney
what do most patients who receive kidney transplants usually develop
Hep C and liver disease
what is a common finding in single-lung transplants
unequal breath sounds
S/S of lung transplant rejection
hemothorax, cough, dyspnea, vomiting, fever, crackles, rhonchi, decrease in oxygenation
most common rejected or failed organ transplant
pancreas
what do patients with pancreatic transplants present with
chronic non-anion gap acidosis because bicarb produced by pancreas drains directly into bladder for secretion
