Chapter 21 Allergy and Anaphylaxis

What is the dose of epinephrine contained in an adult EpiPen? 0.15 mg 0.3 mg 1 mg 3 mg

0.3 mg

The effects of epinephrine are typically observed within _________ following administration. 1 minute 30 seconds 30 minutes 1 hour

1 minute

When assessing a patient's breathing, you hear wheezing in all lung fields. What are you hearing? A high-pitched whistling sound caused by bronchoconstriction A coarse, low-pitched breath sound heard in patients with chronic mucus in the upper airways A high-pitched noise heard primarily on inspiration Crackling, moist breath sounds

A high-pitched whistling sound caused by bronchoconstriction

What is a wheal? Widespread areas of generalized itching and/or burning that appear as multiple raised areas on the skin A poison or harmful substance A raised, swollen, well-defined area on the skin Swelling of the tongue

A raised, swollen, well-defined area on the skin

You find the child on the back porch, in obvious distress, leaning forward in a chair with his elbows on his knees, struggling to catch his breath. Due to severe dyspnea, he is unable to answer your questions. You also notice that his left arm is in a cast. Your partner immediately applies a nonrebreathing mask as you complete the primary assessment. The child's respirations are rapid and shallow, and his pulse is rapid and thready. His skin is pale with patches of raised red spots on his hands, arms, and face. Your partner conducts a systematic rapid physical exam as you obtain vital signs and a SAMPLE history from the mother. When you inquire about allergies, the mother tells you the child had a very mild reaction to a bee sting several months ago. What possible chemical is being released into this patient's body during this reaction? A. Histamine B. Antihistamine C. Epinephrine D. Glucose

A. Histamine

10.When administering epinephrine by auto-injector, the EMT should hold the injector in place for: A.3 seconds. B.10 seconds. C.20 seconds. D.30 seconds.

A.3 seconds.

Which of the following patients has the most significant chance of having a contraindication to epinephrine? A 6-year-old with significant peanut allergies An 80-year-old male with a history of acute coronary syndrome A 47-year-old female with bronchospasms A teenager with no history of allergies

An 80-year-old male with a history of acute coronary syndrome

You and your partner are dispatched to 1284 NW 152 Avenue for a child experiencing respiratory distress. On arrival, a frantic woman meets you at the door and begs you to hurry. She informs you that her 12-year-old son was playing in the backyard when he felt a sudden pain on the back of his leg. You find the child on the back porch, in obvious distress, leaning forward in a chair with his elbows on his knees, struggling to catch his breath. Due to severe dyspnea, he is unable to answer your questions. You also notice that his left arm is in a cast. Your partner immediately applies a nonrebreathing mask as you complete the primary assessment. The child's respirations are rapid and shallow, and his pulse is rapid and thready. His skin is pale with patches of raised red spots on his hands, arms, and face. Your partner conducts a systematic rapid physical exam as you obtain vital signs and a SAMPLE history from the mother. When you inquire about allergies, the mother tells you the child had a very mild reaction to a bee sting several months ago. His medical history also includes asthma, anxiety, and a recent fracture of his arm. Your partner informs you that he heard wheezes in all lung fields and observed additional raised red spots on the child's chest. Which medications should be administered for this patient? A. Albuterol then epinephrine B. Epinephrine then albuterol C. Acetaminophen (Tylenol) then albuterol D. Diphenhydramine (Benadryl) then Epinephrine

B. Epinephrine then albuterol

A 38-year-old woman was bitten by fire ants while at the park. Your primary assessment reveals that she is semiconscious: has labored breathing, and has a rapid thready pulse. She has a red rash on her entire body, and her face is swollen. You should: A. place her supine with her legs elevated B. assist her ventilations with 100% oxygen. C. perform a rapid secondary assessment D. locate the area where the fire ants bit her

B. assist her ventilations with 100% oxygen.

6.A young male is experiencing signs and symptoms of anaphylactic shock after being stung by a scorpion. His level of consciousness is diminished, his breathing is severely labored, you can hear inspiratory stridor, and his face is cyanotic. The patient has a prescribed epinephrine auto-injector. What should you do first? A.Assist him in administering his epinephrine. B.Apply high-flow oxygen via nonrebreathing mask. C.Provide ventilatory assistance with a bag-mask device. D.Elevate his legs and cover him with a warm blanket.

C.Provide ventilatory assistance with a bag-mask device.

3.You are called to a local baseball park for a 23-year-old man with difficulty breathing. He states that he ate a package of peanuts approximately 30 minutes ago and denies any allergies or past medical history. Your assessment reveals widespread urticaria, tachycardia, and a BP of 90/60 mm Hg. You can hear him wheezing, even without a stethoscope. You should be MOST suspicious of a(n): A.acute asthma attack. B.mild allergic reaction. C.anaphylactic reaction. D.moderate allergic reaction.

C.anaphylactic reaction. Mild reactions usually appear with urticaria, itching, and some swelling, but not hypotension and breathing difficulties.

2.The negative effects associated with anaphylactic shock are the result of: A.severe internal fluid loss. B.inadequate pumping of the heart. C.vasodilation and bronchoconstriction. D.the nervous system's release of adrenaline.

C.vasodilation and bronchoconstriction.

1.The signs and symptoms of an allergic reaction are caused by the release of: A.histamine. B.epinephrine. C.leukotrienes. D.both histamine and leukotrienes.

D.both histamine and leukotrienes.

Which of the following categories of allergens is the most common? Chemical Food Insect bites and stings Medication

Food

Which of the following are late signs of an allergic reaction? Sneezing Hypotension Tachycardia Cyanotic, cool skin

Hypotension Cyanotic, cool skin

Why is epinephrine used for anaphylaxis? It stops the allergic reaction from progressing. It reverses bronchoconstriction and vasodilation. It slows tachycardia. It decreases blood flow.

It reverses bronchoconstriction and vasodilation.

Immediately after giving an epi-injection, you should: A. reassess the patient's vital signs B. properly dispose of the syringe C. notify medical control of your action D. record the time and dose

Properly dispose of the syringe

You have responded to a scene where the 33-year-old male patient is in obvious respiratory distress, breathing rapidly with audible wheezing, and with flushed red skin that is covered in hives. When you attempt to question the patient, you find he can speak in only two- to three-word sentences. Respirations are 28 breaths/min and labored. Pulse is 120 beats/min. Skin is pale and cool, with widespread urticaria and angioedema of the lips. Blood pressure is 88/60 mm Hg and SpO2 is 88%. Which of the following interventions should you administer first? Provide high-concentration oxygen. Administer epinephrine. Give the patient a nonsteroidal anti-inflammatory drug. Give the patient an antihistamine.

Provide high-concentration oxygen.

You are treating a child with a bee sting. The stinger is still embedded in the child's skin. What should you do? Remove the stinger with tweezers. Leave the stinger in place. Scrape the skin with the edge of a stiff object. Squeeze the area around the stinger.

Scrape the skin with th edge of a hard object.

Which of the following patients would most likely have a delayed onset of an allergic reaction a 45-year-old male who ingested penicillin a 30-year-old man who was stung by a bee a 21-year-old female who inhaled pollen a 50-year-old male who was exposed to latex

a 45-year-old male who ingested penicillin

Common signs and symptoms of an allergic reaction include all the following except: A. fushing of the skin B. persistent dry cough C. abdominal cramps D. drying of the eyes.

drying of the eyes.

when auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates: a significant amount of fluid in the lungs rapid swelling of the upper airway tissues enlargement of the bronchioles in the lungs narrowing of the bronchioles in the lungs

narrowing of the bronchioles in the lungs

You are responding to a call where an 8-year-old has been stung by a wasp. His skin is pale with patches of raised red spots on his hands, arms, and face. These spots are most likely: angioedema. acne. urticaria. a fungal infection.

urticaria

Two of the most common symptoms of anaphylaxis are: urticaria and angioedema hypertension and swollen hands expiratory stridor and tachycardia watery eyes and localized itching

urticaria and angioedema

epinephrine Is indicated for patients with an allergic reaction when: A. wheezing and hypotension are present B. the reaction produces severe urticaria C. the patient is anxious and tachycardic D. a paramedic is present at the scene

wheezing and hypotension are present