chapter 33 assessment and management of patients with allergic disorders

The nurse is teaching a group of health care workers about latex allergies. What reaction will the nurse teach the workers to be most concerned about with laryngeal edema?

IgE mediated hypersensitivity

A patient has been diagnosed with an allergy to peanuts. What is a priority for this patient to carry at all times?

an epipen

The nurse knows the best strategy for latex allergy is

avoidance of latex based products

The nurse is preparing to administer a medication that has an affinity for H1 receptors. Which medication would the nurse administer?

diphenhydramine

which term refers to an incomplete antigen?

hapten

The nurse is teaching a client about allergic rhinitis and its triggers. What is the most common trigger for the respiratory allergic response?

plant pollen

A patient asks the nurse if it would be all right to take an over the counter antihistamine for the treatment of a rash. What should the nurse educate the patient is a major side effect of antihistamines?

sedation

a client reports to a health care provider's office for intradermal allergy testing. Before testing, the nurse provides client teaching. Which statement indicated a need for further education?

"if i notice tingling in my lips or mouth, gargling may help the symptoms"

A nurse comes to the employee health center for evaluation and is diagnosed with allergic contact dermatitis related to latex. What manifestation would the nurse most likely exhibit?

Blistering

A client develops a facial rash and urticaria after receiving penicillin. Which laboratory lab value does the nurse expect to be elevated?

IgE

Which of the following is the most frequent route of exposure to a latex allergy?

cutaneous

a client with an allergic disorder calls the nurse and asks what treatment is available for allergic disorders. The nurse explains to the client that there is more than one treatment available. What treatments would the nurse tell the client about?

desensitization

A client calls the clinic and asks the nurse if using oxymetazoline nasal spray would be alright to relieve the nasal congestion the client is experiencing due to seasonal allergies. What instructions should the nurse provide to the client to avoid complications?

do not over use the medication as rebound congestion can occur

When assessing the skin of a client with allergic contact dermatitis, the nurse would most likely expect to find irritation at which area?

dorsal aspect of the hand

A patient is experiencing an allergic reaction to a dose of penicillin. What should the nurse look for in the patient's initial assessment?

dyspnea, bronchospasm, larygenal edema

Which body substance causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle?

histamine

The nurse is working in an allergy clinic is preparing to administer skin testing to a client. Which route is the safest for the nurse to use to administer the solution?

intradermal

After teaching a client how to self administer epinephrine, the nurse determines that the teaching plan has been successful when the client demonstrated which action?

jabs the autoinjector into the outer thigh at a 90 degree angle

A nurse is reviewing the dietary history of a client who has experienced anaphylaxis. What would the nurse identify as a common cause of anaphlyaxis?

milk eggs shrimp

What is the most common cause of anaphylaxis?

penicillin

The nurse is completing the intake assessment of a client new to the allergy clinic. The client states that he was taking nose drops 6 times a day to relieve his nasal congestion. The nasal congestion increased, causing him to increase his usage of the nasal spray to 8 times a day. But again the congestion worsened. The nurse communicates to the health care provider that the client experienced

rhinitis medicamentosa

The nurse is working with a colleague who has delayed hypersensitivity (type iv) allergic reaction to latex. Which statement describes the clinical manifestation of this reaction?

symptoms are localized to the area of exposure, usually the back of the hand

A nurse is preparing a discharge teaching plan for a client with atopic dermatitis. Which instruction should the nurse include in the teaching plan?

use a topical skin moisturizer daily

A college student reports the onset of skin burning and hives when walking outdoors in cold weather. Which suggestions will the nurse make to limit this reaction from occuring?

use a wetsuit when planning to go swimming in cold weather avoid ingesting foods and beverages that are cold in temperature take an over the counter antihistamine before going outdoors in cold weather

The nurse explains to a client that immunotherapy initially starts with injections at which interval?

weekly

A patient received epinephrine in response to an anaphylactic reaction at 10:00 am. The nurse knows to observe the patient for a "rebound" reaction that may occur as early as

2 pm

A patient comes to the clinic with pruritus and nasal congestion after eating shrimp for lunch. The nurse is aware that the patient may be having an anaphylactic reaction to the shrimp. These symptoms typically occur within how many hours after exposure?

2 hours

What education should the nurse provide to the patient taking long term cortiocsteroids?

The patient should not stop taking the medication abruptly and should be weaned off of the medication

The nurse is administering intravenous vancomycin. What will the nurse initially assess the client for if an allergic reaction occurs?

dyspnea, bronchospasm, laryngeal edema

The nurse is working with a client with allergic rhinitis. What medication does the nurse anticipate will be prescribed to treat the allergic rhinitis?

fexofenadine

The nurse is reviewing various medications with a client that can be used to treat allergic disorders. What medication will the nurse identify as an intranasal cortiosteroid?

fluticasone

A nurse is working in a dermatology clinic with clients who have allergies. What is the most important chemical mediator involved in the allergic response?

histamine

The nurse is teaching a client with allergic rhinitis about medications. what medication is the mast cell stabilizer used in the treatment of allergic rhinitisi?

intranasal cromolyn sodium

Which intervention is the single most important aspect for the client at risk for anaphylaxis?

prevention

The nurse is planning care for a client with atopic dermatitis. Which information will the nurse include when teaching the client self - care for the condition?

use mild soap when bathing wear clothing made of cotton apply a skin cream that contains glycerol

An infant is born to a mother who had no prenatal care during her pregnancy. What type of hypersensitivity reaction does the nurse understand may have occured?

Rh-hemolytic disease

The nurse is evaluating a client's readiness for allergy skin testing. The nurse determines that the testing will need to be postponed when it is revealed that the client took which classification of medication the night before?

antihistamine

The nurse is teaching a client about contact dermatitis. What type of contact dermatitis requires light exposure in addition to allergen contact?

photoallergic

A client has been taking a decongestant for allergic rhinitis. During a follow up visit, which finding suggests that the decongestant has been effective?

reduced sneezing

The nurse is teaching a client about the symptoms of anaphylaxis. Which client statements indicate no further teaching is needed?

"if i start having difficulty breathing, I need to get help right away" "peripheral tingling is a symptom of anaphylaxis reaction"

A patient was seen in the clinic 3 days previously for allergic rhinitis and was given a prescription for a corticosteroid nasal spray. The patient calls the clinic and tells the nurse that the nasal spray is not working. What is the best response by the nurse?

"the full benefit of the medication may take up to 2 weeks to be achieved."

The nurse is administering a sympathomimetic drug to a patient. What areas of concern does the nurse have when administering this drug?

causes bronchodilation constricts integumentary smooth muscle dilates the muscular vasculature

The nurse is teaching a client about a recent order for loratadine to help with seasonal allergies. What client statement indicates no further teaching is required?

taking my medication on an empty stomach is a must sucking on ice chips will help if my mouth is dry being careful driving is important after taking the medication it is recommended that i buy a humidifier for my bedroom

The nurse tells the client that if the exposure to an allergen occurs around 8 am, the the client should expect a mild or moderate reaction by what time?

10 am

The nurse is evaluating the plan of care for a client with an allergic disorder who has a nursing diagnosis of deficient knowledge related to measures for allergy control. what client statement will indicated to the nurse that the outcome has been met?

client identifies methods for reducing exposure risk to allergens

When evaluating a client's knowledge about the use of antihistamines, what statement indicated further education is required?

"if i am pregnant, i should talk half the dose"

A client has been having joint pain and swelling in the left food and is diagnosed with rheumatoid arthritis. The symptoms began suddenly without any identifiable cause, and the client has significant joint destruction. What type of disease is this considered?

autoimmune

The nurse is teaching a client after a medication allergic reaction has occured. What is the most important action for the nurse to teach the client to take to prevent anaphylaxis?

avoid potential allergens

A client has begun sensitivity testing to determine the allergen which caused an anaphylactic reaction 3 weeks ago. In scratch testing, Which part of the body is more sensitive to allergens?

back

Which type of hypersensitivity occurs when the system mistakenly identifies a normal constituent of the body as foreign?

cytotoxic

Which allergic reaction is potentially life threatening?

angioedema

The nurse observes diffuse swelling involving the deeper skin layers in a client who has experienced an allergic reaction. The nurse would correctly document this finding as

angioneurotic edema