Matson Flashcards
Primary role of immune system
Discriminate self vs non self
Allergies
Overrecation of immune system to a normally harmless substance
Sensitization Stage (3)
Antigen (allergen) enters the body
Plasma cells produce IgE
I’ve attaches to mast cell (found throughout tssiue )
Subsequent Response
Antigen enters the body, attaches IgE
Attachment to IgE triggers the release of chemical mediators
Chemical Mediators (define)
Responsible FOR S/S
Of allergies
Chemical mediators : intravascular compartment
Rt to blood vessel Anaphylaxis
Chemical mediators :Skin (HRF)
Erythema
- Utacaria (hives)= pink raised edematous itchy areas
- Atopic dermatitis = interstitial edema
- Wheat-flare reaction (large welts) = pale wheal edemtous fluid surrounded by a red flare from hypermia ( mosquito bite)
- Angioedema (swelling of lips, eyes)
Chemical mediators :Respiratory
Rhintins = hay fever nasal discharge, sneezing, tearing AIREAY OBSTRCUSTION
Asthma - thick sputum
Chemical mediators : GI
N/V/D
CRAMPING
Most common chemi Al mediators
Histamine
Seriontin
Leukotrienes
Prostgoadins
Modes of entry
Inhalation
Ingestion
Injection
Skin contact
Drug Therapy for allergies
Anhistamaines( Benadryl, Claritin, Zyrtec)
Antipruritic drugs (calamine lotion)
Corticosteroids (to decrease inflammation)
Antihistamines (benadryl, claritin, zyrtec)
( mechnaism , side effects, nursing actions)
- benadryl = blocks histamine release , relieve acute allergic symptoms
S/E= cross BBB causes sedation + nervousness, restlessness. Anticholngeric reaction( can’t see, can’t shit, can’t spit)
Nursing Actions: warn pt that operating machinery, report applications, change in HR, change in bowel. NO ETOH
- Zyrtec+ Clartin= same above
S/E= limited brain receptors causing minimal sedation and effects
Nursing Actions= teach pt about cost and less side effects
- Steroid = inhibits response of rhinits, decreasing muscousl inflammation
S/E= mild irritation, mucousal nose drying, nosebleeds, fungal infections
Nursing Actions= adherence important. Teach pt to use regular basis not PRN. Have pt clear nsal passages before use. Stop if nasal infection
Calamine
Provide relief from itching, skin protected
Growth and Developmental Consderations
- Infants: usually a skin reaction, often food related
- Child: allergic rhinitis is most common
- Adolescents: new environments, trying new foods = new allergies
- Middle adulthood: less likely to develop new allergies, but possible
- Elderly: may not know they are allergic to newer antibiotics b/c they haven’t taken them
Assess for allergies, but also ask
what the reaction is like? Is it just a rash? Is it anaphylaxis?
Anaphylaxis:
acute clinical syndrome resulting from interaction of an allergen in a hypersensitive patient
- Excess release of chemical mediators, systemic reaction- life threatening, medical emergency
Cause: injections, inhalation, ingestion, topical
Causes of anaphylaxis
Animal Sera (DTAP, RABIES, SNAKE VENOM, TETANUS)
Drugs (ASPRIN, CEHALOSPROINS, CHEMO, INSULIN, LOCAL ANETSHIC, NSAIDS, PENICILLINS, SULDANOMIDES, TETRACYLINE)
Good (EGGS, MILL NUTS, PEANUST, SHELLFISH, FISH, CHOCOLATE)
Insect (WASPS, HORNET, YELLOW JACKETS, BUMBLEEBEES, ANTS)
Treatment ( ALLERGY EXTRACT, BLOOD PRODUCTS, IODINE CONTRAST)
S/S of Anaphylaxis Neuro
- Headache, dizziness
- Paresthesia
- Feeling of impending doom
S/S of Anaphylaxis Skin
Skin:
- Pruritus (itchy)
- Angioedema (swelling of lips and eyes etc)
- Erythema
- Urticaria (hives)
S/S anaphylaxis Respiratory
bronchial restriction
- Hoarseness, coughing
- Sensation of narrowing airway
- Wheezing, stridor, dyspnea
- Tachypnea
- Respiratory arrest
S/S of anaphylaxis : Cardiovascular
- Hypotension
- Dysrhythmias, tachycardia
- Cardiac arrest
S/S Anaphylxis GI
- N/V/D
CRAMPING, ABD PAIN
Nursing Interventions: Anaphylaxis
Treat for Shock!!!
Ensure airway
Remove stinger
Establish IV
- Epinephrine: FIRST INTERVENTION must be IM OR IV BE AWARE FOR BET BLOCKER PTS BC THEY MAY BE REISTANT ( hypotension n bradycardia) give glucagon
- Causes vasoconstriction = increased BP
- Relaxes bronchial smooth muscles = less bronchial constriction
- Given IM, usually outer thigh, but can also be given IV/SQ
- MUST go to ED for observation
- HRF biphasic reaction for 4 hours
- 0.01mg/kg-0/3mg/kg for children
- 0.3-0.5mg/dose for adults
- Q5-15min PRN
GIVE O2
Albuterol for bronchospasm
Diphenhydramine
Corticosteroid
Anaphhylaxis : Antihistamines
- Block the effect of histamine (a chemical mediator)
- Ineffective w/ acute bronchoconstriction
Anaphylaxis: Cortcosteriod
Corticosteroids:
- Decreases the amount of chemical mediators
- Usually given IV
- Will decrease any edema that is present
- Methylprednisolone is most common
Anaphylaxis: Vassopressors
Vasopressors: given if hypotensive to raise BP
- Ex: norepinephrine IV
Anaphylaxis IVF
isotonic
- Helps increase/maintain BP
- Adults: 1L IV bolus
- Children: 20ml/kg/hr
Anaphylaxis : Bronchodilators
Decreases bronchoconstriction
Allergic Rhinitis:
inflammation of nasal mucosa
- Causes: seasonal (pollen) or perennial (environmental) allergens
- Exposure to allergen leads to IgE and inflammation in nasal cavity
Allergic Rhinitis symptoms ( episodic, intermittent, persistent )
Frequency of symptoms:
- Episodic: sporadic exposure (you go to a friends house who has a cat)
- Intermittent: less than 4 days a week or less than 4 weeks/year
- Persistent: more than 4 days a weeks or greater than 4 weeks/year
Allergic Rhinitis Manifest
Manifestations:
- Sneezing, watery itchy eyes/nose
- Congestion, decreased smell
- Pale, boggy, swollen turbinates
- Chronic exposures: headache, nasal congestion w/ sinus pressure, hoarseness, cough
(d/t nasal polyps), post nasal drip
- Allergic tongue
- Allergic crease
Epine
-check expiration date
Inject drugs at 90 degree, hold for 2-3 seconds, inject through clothes
After use call 911 take injector with you
