Sherpath: Allergic Reactions
The mother of a patient with nasal congestion, fatigue, and frequent sneezing states that this is the second time in the last 3 months that her child has had these symptoms. She requests that the child receive an allergy test to identify what is causing the recurring symptoms. Which statement would indicate the need for further education about signs and symptoms of allergic rhinitis? "He has a wrinkle on the bridge of his nose." "The symptoms get worse after he plays outside." "His drainage was clear, but this morning it turned yellow." "I've been putting lip balm on his mouth because it's very dry."
"His drainage was clear, but this morning it turned yellow." Yellow nasal discharge is most often a symptom of nasopharyngitis, whereas in allergic rhinitis rhinorrhea is typically clear. This statement would indicate the need for further education about symptoms of allergic rhinitis.
The nurse is caring for a child with seasonal allergic rhinitis. Which statement from the child's parents would indicate the need for further education regarding allergic rhinitis? "We have her play inside most of the time." "We have closed the cat door so the cat stays inside." "We give her oral antihistamine only during spring time." "We make sure to wash her hair after she's been outside."
"We have her play inside most of the time." Having the child play inside is a not the most effective way to manage allergic rhinitis. Therefore, this statement would indicate a need for further teaching.
Which patient would require immediate administration of epinephrine? A patient who reports a bright red rash after hiking outdoors A patient receiving penicillin infusion who reports tingling of the lips and tongue A patient who comes into the clinic after horseback riding and reports itchy eyes and runny nose A patient receiving cephalosporin treatment who develops raised red welts on the shoulders and chest
A patient receiving penicillin infusion who reports tingling of the lips and tongue A patient reporting tingling of the lips and tongue requires immediate administration of epinephrine. This patient's symptoms are characteristic of anaphylaxis.
An adolescent develops hives and swollen lips after a bee sting. What is the priority nursing intervention for this patient? Administer epinephrine as prescribed. Administer corticosteroids as prescribed. Administer diphenhydramine as prescribed. Carefully observe the patient for worsening of symptoms.
Administer epinephrine as prescribed. The adolescent appears to be experiencing anaphylaxis. Administration of injectable epinephrine via an EpiPen or other delivery system is the most important intervention.
A child comes into the school nurse office with slurred speech, itching of the head and shoulders, and swollen lips. Which action should the nurse take first? Call 911. Have the child lie down. Administer the child's EpiPen injection. Administer the child's prescribed diphenhydramine.
Administer the child's EpiPen injection. This child is showing signs of anaphylaxis, which should be treated immediately. The nurse should administer epinephrine first because it may be only a matter of minutes before shock occurs.
A nurse is caring for the parents of a child with allergic rhinitis. The parents state that since the child takes the prescribed antihistamines before bed, and since both the antihistamines and the child's mouth breathing cause dryness, they have placed a humidifier in the child's room at night. This demonstrates the need for further education on which aspect of managing allergic rhinitis? Air quality control Medication side effects Adequate patient hygiene Recognizing signs and symptoms of allergic rhinitis
Air quality control Use of a humidifier may encourage mold growth and cause the spread of allergens inside the child's room. The parents' statements indicate the need for further education regarding air quality control. Incorrect
Which of the following answers accurately describes an allergy? A deficit in one or several aspects of immune function An immune-mediated attack on the body's own systems An excessive and inappropriate immune response to a harmless antigen An effect of some medications or disease states that inhibits one or many aspects of the immune system
An excessive and inappropriate immune response to a harmless antigen An allergy is an excessive and inappropriate immune response to a harmless antigen (an allergen).
A patient is brought to the clinic and is diagnosed with glomerulonephritis. Which statement describes the interaction of molecules involved in this allergic reaction? IgE attaches to mast cell and basophil causing release of histamine. Antigen binds with antibodies and the structure then deposits into tissues. Antigen stimulates IgE, which then activates complement, eventually leading to cell damage. Sensitized T-cells come in contact with antigen on re-exposure causing tissue damage from cytokine release.
Antigen binds with antibodies and the structure then deposits into tissues. While local inflammation can be caused by a topical allergic reaction, this patient's symptoms are not characteristic of a topical allergic reaction. This state reflects what happens in a patient with glomerulonephritis, which is a type III allergic reaction.
A patient is brought into the emergency department with anaphylaxis due to an insect sting on the arm. After establishing a patent airway and administering epinephrine, which action should the nurse perform first? Start an IV line. Administer the prescribed corticosteroids. Administer the prescribed antihistamines. Apply a tourniquet to the affected extremity.
Apply a tourniquet to the affected extremity. In order to contain the allergen, the nurse should apply a tourniquet to the affected extremity proximal to the site of the sting. This is the action the nurse should perform first after establishing a patent airway and administering epinephrine.
The nurse is educating parents on preventative measures to take for their child who has a severe bee allergy. During the instruction it is important for the nurse to include which advice on the biphasic reaction associated with use of the EpiPen? Place ice on the sting and area of injection, and provide plenty of oral fluids. Administer a low dose of an antiinflammatory medication to help reduce any pain experienced by the child. Ensure the child receives plenty of rest immediately after the injection. Bring the child to the emergency department because there may be another reaction. Administer a double dose of antihistamine to the child and provide plenty of oral fluids.
Bring the child to the emergency department because there may be another reaction. The biphasic reaction can occur in instances of anaphylaxis. This means even after being treated with epinephrine, a second reaction can occur with the same level of severity. A visit to the emergency department should be advised after an EpiPen injection.
A pediatric patient presents to the urgent care clinic after the parent suspects the child is experiencing an allergy to a prescribed antibiotic. Which assessment finding would be most concerning to the nurse? Flushing of the face Increased heart rate Complaints of feeling warm Difficulty speaking and catching his breath
Difficulty speaking and catching his breath Difficulty speaking and catching one's breath can indicate laryngospasm in the patient experiencing a type I reaction. The patient is at risk for airway compromise. This is the most concerning finding.
A preschool child at a daycare center was given an EpiPen injection for presumed anaphylaxis and has been transported to the hospital. Prioritize the next steps of care in the order the care team should take them.
Ensure adequate airway. Administer epinephrine. Place an IV line. Administer corticosteroids and/or antihistamines.
A child presents to the clinic with swelling of the lips and tongue, severe flushing, and pruritus. Which medication should the nurse administer first? Cetirizine Prednisone Epinephrine Diphenhydramine
Epinephrine Epinephrine is the first-line medication used to treat anaphylaxis.
A 5-year-old child exhibits itchy, watery eyes and nose, and sneezing. Which nursing care action is performed first to support a diagnosis of allergic rhinitis? View patient chest x-ray. Order a complete blood count. Perform skin prick/puncture test. Examine patient and family history.
Examine patient and family history. A thorough personal and family history usually elicits a description that suggests an allergic rather than infectious pattern and should be the first step in assessment.
A child presents with red-raised skin lesions and is diagnosed with contact dermatitis. What is the most likely cause of this allergic reaction? An insect sting Ingestion of nuts Inhalation of pollen Exposure to poison ivy
Exposure to poison ivy Contact dermatitis is a localized, cutaneous manifestation of an allergy that is often caused in children by contact with poison ivy. Therefore, it is likely that this patient's reaction was caused by exposure to poison ivy.
A patient with clear rhinorrhea and itchy eyes and ears reports more frequent symptoms after outdoor play. What is the first step in alleviating the patient's symptoms? Dry the child's shoes. Keep low humidity in the house. Have the child bathe after coming inside. Wash the child's sheets and blankets in hot water.
Have the child bathe after coming inside. If the child bathes and washes his or her hair after coming inside, it can remove pollen and dander and reduce further exposure to the allergen.
A child presents with swelling of the lips and tongue, severe flushing, and pruritus. Which chemical mediator is likely responsible for these symptoms? Histamine Epinephrine Corticosteroid Diphenhydramine
Histamine The child is displaying signs and symptoms of anaphylaxis. Histamine release by mast cells is the cause of many of the signs and symptoms of anaphylaxis.
A child has a family history of allergies. He has lately been having trouble concentrating and has grown increasingly drowsy. Which suggestion can the nurse make to help alleviate this child's symptoms? Take allergy medications at night before bed. Keep an EpiPen close by for fast administration. Wash hair in the morning before going outside. Limit the child's play time so they can go to bed earlier.
Take allergy medications at night before bed. Allergic rhinitis can impair concentration and antihistamines can cause drowsiness. To solve this problem, the antihistamines for allergic rhinitis should be taken before bed.
Which condition is a manifestation related to a cytotoxic reaction? Hives caused by a medication allergy Dermatitis after contact with poison ivy Serum sickness after antibody administration Transfusion reaction due to incompatible blood type
Transfusion reaction due to incompatible blood type A transfusion reaction after receiving incompatible blood is an example of a cytotoxic reaction.
