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AHII - Chapter 18
| Question | Answer |
|---|---|
| Patient’s 1st dose of medication… | NEVER DELEGATE -> you as the RN always administer to monitor response |
| Hypersensitivity (Allergy) | Overactive immunity with excessive inflammation occurring in response to the presence of an antigen to which the patient usually has been previously exposed; the predisposition to have allergies is genetic, but specific allergies aren’t inherited; 4 types |
| Type I: Rapid or Immediate (Atopic Allergy) | Most common; reaction of IgE antibody on mast cells with antigen, which results in release of mediators, especially histamine; ex of type I: angioedema, anaphylaxis, & allergic asthma; ex of atopic: hay fever, rhinosinusitis, latex allergy, & peanuts |
| Allergens can be contacted in these ways: | Inhaled, ingested, injected, or skin or mucous membrane contacted |
| Histamine | The most common vasoactive amine; short-acting biochemical; results in the five cardinal signs of inflammation |
| Five cardinal signs of inflammation | 1) warmth 2) redness 3) swelling 4) pain 5) decreased function |
| Type II: Cytotoxic | Occurs when the body makes autoantibodies directed against self cells that have some form of foreign protein attached to them; ex: hemolytic anemias, immune thrombocytopenic purpura, & hemolytic transfusion reactions |
| Type III: Immune Complex-Mediated | Result from excess antigens causing immune complexes to form in the blood -> lodge in small blood vessels of the kidneys, skin, & joints -> trigger inflammation & tissue or vessel damage results; ex: autoimmune disorders |
| Type IV: Delayed | Have T-cells as the activated immune system component triggering the excessive responses; occurs hours-days after exposure; ex: PPD test for TB; corticosteroids help; histamine antagonists don’t & IgE doesn’t cause the reaction, so no desensitization |
| Angioedema | Severe type I reaction that involves the blood vessels & all layers of the skin, mucous membranes, & subcutaneous tissues in the affected area; most often seen in the lips, face, tongue, larynx, & neck; drugs associated: NSAIDs & ACEIs for hypertension |
| Angioedema interventions | Oxygen, corticosteroids, & epinephrine; indications for intubation are the presence of strider & the inability of the patient to swallow; if intubation is not possible, emergency tracheostomy is needed |
| Anaphylaxis | Condition in which a type I reaction involves of all blood vessels & bronchiolar smooth muscle, causing widespread blood vessel dilation, decreased cardiac output, & bronchoconstriction within seconds to minutes after allergen exposure |
| Anaphylaxis health promotion & maintenance | Teach the patient with a history of allergic reactions to avoid known allergens, to wear a medical alert bracelet, & to alert health care personnel about specific allergies |
| A patient is considered to have anaphylaxis whenever any one of these 3 criteria is met: | 1: skin or mucous membrane probs alone with either respiratory distress or hypotension/reduced perfusion 2: 2 or more of either skin/mucous membrane probs, respiratory distress, hypotension/reduced perfusion, or GI probs 3: hypotension *pg. 350 chart |
| Anaphylaxis interventions | Assess gas exchange 1st; epinephrine -> antihistamines -> oxygen |
Created by:
tatianalopez03
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