Med Surg: Chapter 37

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

photoallergic

A client is presenting an anaphylactic response to unknowingly ingesting nuts at a family celebration. What type of hypersensitivity did this client exhibit? type IV type I type III type II

type I

What are expected client outcomes the nurse would include in a plan of care for a client with allergic rhinitis? Select all that apply. The client controls outdoor precipitating factors The client develops cachexia The client's lungs will have occasional crackles or rhonchi The client reports no symptoms of peripheral tingling The client will wear a dampened mask if dust is a problem

The client will wear a dampened mask if dust is a problem The client reports no symptoms of peripheral tingling The client controls outdoor precipitating factors

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 Lupus erythematosus Rh-hemolytic disease Rheumatoid arthritis

Rh-hemolytic disease

T-cell deficiency occurs when which gland fails to develop normally during embryogenesis? Thyroid Pituitary Adrenal Thymus

Thymus T-cell deficiency occurs when the thymus gland fails to develop normally during embryogenesis.

A client calls the clinic and asks the nurse if using oxymetazoline nasal spray would be alright to relieve the nasal congestion he is experiencing due to seasonal allergies. What instructions should the nurse provide to the client to avoid complications? Do not overuse the medication as rebound congestion can occur. Taper the dose when discontinuing the medication. Do not operate machinery or drive while using the medication. Report white patches in the mouth because the medication can cause a fungal infection.

Do not overuse the medication as rebound congestion can occur.

When evaluating a client's knowledge about use of antihistamines, what statement indicates further education is required? "If I am pregnant, I should take half the dose." "I should be careful when driving." "This medication may be taken with food." "Hard candy will relieve my dry mouth."

"If I am pregnant, I should take half the dose."

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? Angioedema Blistering Rhinitis Laryngeal edema

Blistering

A client with lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder? For their immunosuppressant effects To decrease the body's risk of infection Because an autoimmune disease is a neoplastic disease So the client has strong drug therapy

For their immunosuppressant effects

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 allergic contact IgG antibodies irritant contact

IgE-mediated hypersensitivity

A client has had a "stuffy nose" and obtained an oxymetazoline nasal spray. What education should the nurse provide to the client in order to prevent "rebound congestion"? Drink plenty of fluids. Only use the nasal spray for 3 to 4 days once every 12 hours. Be sure to use the nasal spray for at least 10 days to ensure the stuffiness is gone. Use the medication every 4 hours to prevent congestion from recurring.

Only use the nasal spray for 3 to 4 days once every 12 hours.

Which statement describes the clinical manifestations of a delayed hypersensitivity (type IV) allergic reaction to latex? They are localized to the area of exposure, usually the back of the hands. They can be eliminated by changing glove brands or using powder-free gloves. They may worsen when hand lotion is applied before donning latex gloves. They occur within minutes after exposure to latex.

They are localized to the area of exposure, usually the back of the hands.

A client is prescribed an oral corticosteroid for 2 weeks to relieve asthma symptoms. The nurse educates the client about side effects, which include hypoglycemia. adrenal suppression. diuresis. hypotension.

adrenal suppression.

Which allergic reaction is potentially life threatening? angioedema contact dermatitis urticaria None of the listed allergic reactions is potentially life threatening.

angioedema

The nurse is caring for a client exposed to peanuts with a known allergy. What assessment is considered the most serious manifestation of angioneurotic edema? conjunctivitis abdominal pain urticaria laryngeal swelling

laryngeal swelling

The nurse is teaching a client about allergic rhinitis and its triggers. What is the most common trigger for the respiratory allergic response? mold spores dust mites animal dander plant pollen

plant pollen

A patient with a history of allergies comes to the clinic for an evaluation. The following laboratory test findings are recorded in a patient's medical record: Total serum IgE levels: 2.8 mg/mLWhite blood cell count: 5,100/cu mmEosinophil count: 4%Erythrocyte sedimentation rate: 20 mm/h The nurse identifies which result as suggesting an allergic reaction? Serum IgE level White blood cell count Erythrocyte sedimentation rate Eosinophil count

Serum IgE level

The parents of a child with contact dermatitis are asking questions about the reaction within the immune system. What description regarding contact dermatitis as a type IV hypersensitivity reaction is accurate? the immediate release of chemical mediators a cross-reacting antibody that mistakes a normal constituent of the body as foreign a delayed-type hypersensitivity that is mediated by T cells the involvement of immune complexes formed when antigens bind to antibodies

a delayed-type hypersensitivity that is mediated by T cells

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 indicate to the nurse that the outcome has been met? Client reports an absence of symptoms associated with the allergy. Client identifies methods for reducing exposure risk to allergens. Client demonstrates appropriate coping strategies for dealing with a chronic disorder. Client states the need for coughing and deep breathing.

Client identifies methods for reducing exposure risk to allergens.

The nurse is working with a colleague who has a delayed hypersensitivity (type IV) allergic reaction to latex. Which statement describes the clinical manifestations of this reaction? Symptoms occur within minutes after exposure to latex. Symptoms worsen when hand lotion is applied before donning latex gloves. Symptoms can be eliminated by changing glove brands. Symptoms are localized to the area of exposure, usually the back of the hands. SUBMIT ANSWER

Symptoms are localized to the area of exposure, usually the back of the hands. SUBMIT ANSWER

A client reports to a health care provider's office for intradermal allergy testing. Before testing, the nurse provides client teaching. Which client statement indicates a need for further education? "I may experience itching and irritation at the site of the testing." "I'll go directly to the pharmacy with my EpiPen prescription." "The test may be mildly uncomfortable." "If I notice tingling in my lips or mouth, gargling may help the symptoms."

"If I notice tingling in my lips or mouth, gargling may help the symptoms."

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

Milk Eggs Shrimp

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

Jabs the autoinjector into the outer thigh at a 90-degree angleExplanation: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.

A client being treated for an allergy has been prescribed antihistamines. The Kardex of this client reads as follows: Age: 32; Profession: Carpenter; Lifestyle & diet: Lives alone, average smoker, nonalcoholic, no food preferences, practices yoga; Medical history: Suffers from hay fever, recent urinary tract infection that has been treated successfully. What information from the Kardex is likely to have the greatest implication in educating the client about antihistamine administration? The client's medical history The client's smoking habit The client's profession The client's age

The client's profession-Most antihistamines cause drowsiness, so the nurse should advise the client not to operate machinery or perform tasks that require alertness when taking antihistamines.

The nurse is obtaining a medication history from a patient with allergic rhinitis. The patient states, "I've been on numerous medications over the years and nothing seems to work. Plus I get so tired and sleepy from them." The nurse documents the medications used in the patient's medical record:Diphenhydramine 50 mg orally twice a dayHydroxyzine 25 mg orally three times a dayChlorpheniramine 4 mg orally every 6 hoursFexofenadine 60 mg orally twice a dayWhen reviewing the list, which medication would the nurse identify as causing the least sedation? Chlorpheniramine Diphenhydramine Fexofenadine Hydroxyzine

Fexofenadine Fexofenadine is a second-generation antihistamine considered "nonsedating." Diphenhydramine, hydroxyzine, and chlorpheniramine are first-generation antihistamines associated with sedation.

A client with a history of allergic rhinitis comes to the clinic for an evaluation. The client is prescribed triamcinolone. What will the nurse include when teaching the client about this drug? Place the prescribed number of drops into the conjunctiva. Be aware that some nasal burning and itching may occur. Use ice chips to alleviate the symptoms of dry mouth. Take the drug orally before, with, or after meals.

Be aware that some nasal burning and itching may occur.

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? "I am sorry that you are feeling poorly but this is the only medication that will work for your problem." "You may be immune to the effects of this medication and will need something else in its place." "The full benefit of the medication may take up to 2 weeks to be achieved." "You need to come back to the clinic to get a different medication since this one is not working for you."

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

The nurse tells the client that if exposure to an allergen occurs around 8:00 AM, then the client should expect a mild or moderate reaction by what time? 3:00 PM 10:00 AM 1:00 PM 11:00 AM

10:00 AM pg. 1037

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? 3% to 4% 15% to 40% 5% to 10% 1% to 3%

15% to 40%

The maximum intensity of histamine occurs within which time frame after contact with an antigen? 5 to 10 minutes 15 to 20 minutes 30 to 35 minutes 40 to 45 minutes

5 to 10 minutes

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? Angiotensin receptor blocker Angiotensin-converting enzyme (ACE) inhibitor Vasodilator Beta blocker

Angiotensin-converting enzyme (ACE) inhibitor

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 Antidepressant Anti-inflammatory Anticoagulant

Antihistamine

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

Avoid potential allergens.

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

Desensitization

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

Diphenhydramine

When assessing the skin of a client with allergic contact dermatitis, the nurse would most likely expect to find irritation at which area? Plantar aspects of the feet Ankles Lower arms Dorsal aspect of the hand

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? Hypotension and tachycardia The severity of cutaneous warmth and flushing The presence and location of pruritus Dyspnea, bronchospasm, and/or laryngeal edema.

Dyspnea, bronchospasm, and/or laryngeal edema. pg. 1037

Which term refers to an incomplete antigen? Antibody Hapten Allergen Antigen

Hapten

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

Histamine

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

IgE

The nurse 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? Intravenous Subcutaneous Intradermal Intramuscular

Intradermal

A nurse is caring for a client with atopic dermatitis. Which suggestions for the client by the nurse would be appropriate? Select all that apply. Keep the room temperature at approximately 70 degrees Fahrenheit (21 degrees Celsius). Humidify the home when the heat is on during the winter. Apply topical moisturizers to the skin. Use a strong antibacterial detergent for the laundry. Wear clothing made from synthetic fabrics.

Keep the room temperature at approximately 70 degrees Fahrenheit (21 degrees Celsius). Apply topical moisturizers to the skin. Humidify the home when the heat is on during the winter.

Which intervention is the single most important aspect for the client at risk for anaphylaxis? Wearing a medical alert bracelet Prevention Desensitization Use of antihistamines

Prevention

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. Keep the thermostat above 75° F (23.9° C). Wear only synthetic fabrics. Bathe only three times per week.

Use a topical skin moisturizer daily.

A nurse has developed irritant contact dermatitis from latex glove use. What will the nurse need to avoid? Changing the brand of gloves used Applying silicone agents to the skin Using powder-free gloves whenever possible Using oil-based hand lotion before donning gloves

Using oil-based hand lotion before donning gloves

The nurse knows the best strategy for latex allergy is

avoidance of latex-based products

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? forearm upper arm back chest

back The scratch or prick test involves scratching the skin and applying a small amount of the liquid test antigen to the scratch. The tester applies one allergen per scratch over the client's forearm, upper arm, or back. The back is more sensitive than the arms.

A client visits the employee health department because of mild itching and a rash on both hands. What will the employee health nurse focus on during the assessment interview? laundry detergent or bath soap changes medication allergies life stressors the nurse may be experiencing chemical and latex glove use

chemical and latex glove use.

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 corticosteroid? cromolyn sodium fexofenadine zileuton fluticasone

fluticasone

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 corticosteroid? fexofenadine cromolyn sodium zileuton fluticasone

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? serotonin leukotrienes prostaglandins histamine

histamine

The nurse is working with a client with allergies. What will the nurse use to confirm allergies and decrease the risk of anaphylaxis?

intradermal testing

A client presents at the clinic with an allergic disorder. The client asks the nurse what an "allergic disorder" means. What would be the nurse's best response? "It is a harmless reaction to something in the environment." "It is a hyperimmune response to something in the environment that is usually harmless." "It means you are very sensitive to something inside of yourself." "It is a muted response to something in the environment."

"It is a hyperimmune response to something in the environment that is usually harmless."