Ch 38 allergic reactions

After teaching a client how to self-administer epinephrine, the nurse determines that the teaching plan has been successful when the client demonstrates which of the following? - Avoids massaging the injection site after administration - Jabs the autoinjector into the outer thigh at a 90-degree angle - Pushes down on the grey release cap to administer the medication - Maintains pressure on the auto-injector for about 30 seconds after insertion

- Jabs the autoinjector into the outer thigh at a 90-degree angle To self-administer epinephrine, the client should remove the autoinjector from its carrying tube, grasp the unit with the black tip (injectiing end) pointed downward, form a fist around the device, and remove the gray safety release cap. Then the client should hold the black tip near the outer thigh and swing and jab firmly into the outer thigh at a 90-degree angle until a click is heard. Next, the client should hold the device firmly in place for about 10 seconds, remove the device, and massage the site for about 10 seconds.

The maximum intensity of histamine following antigen contact, occurs within which timeframe? 5 minutes 15 minutes 30 minutes 45 minutes

15 minutes

While monitoring the patient's eosinophil level, the nurse suspects a definite allergic disorder when seeing an eosinophil value of what percentage of the total leukocyte count? 1% to 3% 3% to 4% 5% to 10% 15% to 40%

15% to 40% Explanation: Eosinophils, which are granular leukocytes, normally make up 0% to 3% of the total number of WBCs (Fischbach & Dunning, 2009). A level between 5% and 15% is nonspecific but does suggest allergic reaction. Higher percentages of eosinophils are considered to represent moderate to severe eosinophilia. Moderate eosinophilia is defined as 15% to 40% eosinophils and may be found in patients with allergic disorders.

The nurse is educating a patient with allergic rhinitis about how the condition is induced. What should the nurse include in the education on this topic? Airborne pollens or molds, Ingested foods, Parenteral medications, Topical creams or ointments

Airborne pollens or molds, Allergic rhinitis is induced by airborne pollens or molds, occurring typically in early spring (tree pollen), early summer (rose and grass pollen), and early fall (weed pollen).

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? Sublingual-swallow immunotherapy (SLIT) Desensitization Sublingual-topical immunotherapy (STIT) Resensitization

B. Desensitization Explanation: Desensitization is another option. Desensitization is a form of immunotherapy in which a person receives weekly or twice-weekly injections of dilute but increasingly higher concentrations of an allergen without interruption. SLIT is a form of desensitization therapy. Options C and D are distractors for this question.

Maximum intensity of histamine occurs within which time frame following antigen contact? 15 minutes 5 minutes 30 minutes 45 minutes

Maximum intensity is reached within about 15 minutes after antigen contact. The other time frames are inaccurate.

A nurse is reviewing the dietary history of a client who has experienced anaphylaxis. Which of the following would the nurse identify as a common cause of anaplhylaxis? Select all that apply? Milk Eggs Shrimp Beef Chicken

Milk Eggs Shrimp Explanation: Common food causes of anaphylaxis include peanuts, tree nuts, shelfish, fish, milk, eggs, soy, and wheat. Beef and chicken are not common causes.

x Which of the following interventions is the single most important aspect for the patient at risk for anaphylaxis? Use of antihistamines Desensitization Wearing of medical alert bracelet Prevention

Prevention

Which of the following would the nurse prioritize as the most important action for the patient to take to prevent anaphylaxis? Avoid potential allergens Desensitization Carry an emergency kit Wear a medical alert bracelet

Avoid potential allergens Explanation: Strict avoidance of potential allergens is an important preventive measure for the patient at risk for anaphylaxis. People who have experienced food, medication, idiopathic, or exercise-induced anaphylactic reactions should always carry an emergency kit containing epinephrine for injection to prevent the onset of the reaction upon exposure. Desensitization is based on controlled anaphylaxis, with a gradual release of mediators. Patients who undergo desensitization are cautioned that there should be no lapses in therapy, because this may lead to the reappearance of the allergic reaction when the use of the medication is resumed. The medical alert bracelet will assist those rendering aid to the patient who has experienced an anaphylactic reaction.

Contact dermatitis is considered a type IV hypersensitivity reaction. The nurse is aware that this classification is characterized by which of the following? A.) The immediate release of chemical mediators B.) A cross-reacting antibody that mistakes a normal constituent of the body as foreign C.) A delayed-type hypersensitivity that is mediated by T cells D.) The involvement of immune complexes formed when antigens bind to antibodies

C.) A delayed-type hypersensitivity that is mediated by T cells

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 occurred? Bacterial endocarditis Rh-hemolytic disease Lupus erythematosus Rheumatoid arthritis

Rh-hemolytic disease Explanation: A type II hypersensitivity, or cytotoxic, reaction, which involves binding either the IgG or IgM antibody to a cell-bound antigen, may lead to eventual cell and tissue damage. The reaction is the result of mistaken identity when the system identifies a normal constituent of the body as foreign and activates the complement cascade. Examples of type II reactions are myasthenia gravis, Goodpasture syndrome, pernicious anemia, hemolytic disease of the newborn, transfusion reaction, and thrombocytopenia.

Which of the following is a contraindication for immunotherapy? Use of a beta-blocker Allergic rhinitis Conjunctivitis Allergic asthma

Use of a beta-blocker Explanation: A contraindication of immunotherapy is the use of a beta-blocker or angiotensin-converting inhibitor therapy, which may mask early signs of anaphylaxis. Indications for immunotherapy are allergic rhinitis, conjunctivitis, or allergic rhinitis.

When assessing the skin of a client with allergic contact dermatitis, the nurse would most likley expect to find irritation at which area? aDorsal aspect of the hand bLower arms cAnkles dPlantar aspects of the feet

a. Dorsal aspect of the hand Explanation: With allergic contact dermatitis, irritation is most common on the dorsal aspects of the hand. Irritant, phototoxic, and photoallergic types of contact dermatitis are commonly seen on the hands and lower arms.

A patient was seen in the clinic for hypertension and received a prescription for a new antihypertensive medication. The patient arrived in the emergency department a few hours after taking the medication with severe angioedema. What medication prescribed may be responsible for the reaction? Beta blocker Angiotensin-converting enzyme (ACE) inhibitor Angiotensin receptor blocker Vasodilator

Angiotensin-converting enzyme (ACE) inhibitor Explanation: Several frequently prescribed medications, such as angiotensin-converting enzyme inhibitors and penicillin, may cause angioedema. The nurse needs to be aware of all medications the patient is taking and be alert to the potential of angioedema as a side effect.