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A client comes to the clinic to see the physician, reporting, 'I think I ate something that I am allergic to.' What symptoms would be appropriate for the nurse to ask questions about?
- A. Nasal congestion and coughing
- B. Hives and itching
- C. Sneezing and runny nose
- D. Diarrhea and abdominal cramping
Correct Answer: D
Rationale: Clinical manifestations generally correlate with the manner in which the allergen enters the body. Inhaled allergens usually cause respiratory symptoms, including nasal congestion, runny nose, sneezing, coughing, dyspnea, and wheezing. Contactants cause skin reactions such as hives, which appear as vesicles filled with clear fluid surrounded by a margin of redness, rash, and localized itching. Cramping, vomiting, and diarrhea are associated with ingested food allergens. Allergic skin responses may also occur with allergies to foods.
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A client is scheduled to have a prick test to determine what specific allergens are creating problems for the client. What should the nurse inform the client is involved with the testing?
- A. A concentrated form of the substance is applied to the skin and covered with an occlusive dressing for 48 hours and then examined.
- B. A dilute solution of an antigen is injected intradermally and observed for a wheal.
- C. The skin will be scratched, a small amount of the liquid test antigen will be applied to the scratch, usually on the back.
- D. The client will taste several different possible antigens and observe for wheals.
Correct Answer: C
Rationale: 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 arm. Results of the test are identifiable in as little as 20 minutes. If a raised wheal with localized erythema appears, the tester measures its length and width in millimeters. The client does not taste in any of the skin tests.
A client presents to the clinic with reports of itching and hives after taking an aspirin this morning. What medication does the nurse anticipate administering that blocks histamine receptors?
- A. Diphenhydramine
- B. Flunisolide
- C. Beclomethasone dipropionate
- D. Pseudoephedrine hydrochloride
Correct Answer: A
Rationale: Diphenhydramine is an antihistamine used for allergic reactions. Flunisolide is a nasal decongestant agent and is used locally to the nasal mucosa. Beclomethasone dipropionate is a nasal steroid spray and inhalant. Pseudoephedrine hydrochloride only constricts nasal membranes.
The nurse is caring for a client with chronic fatigue syndrome. What is a realistic nursing intervention when taking care of a client with this diagnosis?
- A. Educate the client about the disease process.
- B. Advise the client to avoid moderate exertion.
- C. Instruct the client to reduce the intake of potassium-rich foods.
- D. Advise the client to avoid being in crowds.
Correct Answer: A
Rationale: The nurse should educate the client about the disease process and the limitations that it requires because nothing, as yet, holds promise for a complete cure. The client need not be advised to avoid moderate exertion because the physician may prescribe a modest exercise program to treat chronic fatigue syndrome. A client who experiences hypotension may be advised to increase salt and water intake but need not reduce the intake of potassium-rich foods or avoid being in crowds.
A client informs the nurse of being very allergic to poison ivy but expresses enjoying and having several camping trips planned for the summer months. What suggestions can the nurse make to protect the client against poison ivy?
- A. Calamine lotion prior to the exposure of the poison ivy and any time skin gets wet
- B. Bentoquatam 5% applied 15 minutes prior to exposure and every 4 hours
- C. Vinegar and water applied to the skin every 2 hours
- D. Diphenhydramine (Benadryl) 50 mg taken prior to the camping trip
Correct Answer: B
Rationale: To protect against poison ivy, clients can apply bentoquatam 5% to the skin 15 minutes prior to exposure and at least every 4 hours as long as risk of exposure continues. The cream forms a protective layer on top of the skin. Calamine lotion can be used for the itching related to poison ivy exposure. Vinegar and water is not an effective way to manage the prevention of poison ivy. Benadryl will not protect against poison ivy.
A client has an allergic reaction to seafood with generalized edema and reports being unable to get a wedding ring off as it is too tight. The client was unable to remove it with soap and water. What action by the nurse can facilitate removal of the ring without damaging it?
- A. Administer a diuretic and wait for the swelling to go down.
- B. There is not another option other than to use a ring cutter to remove the ring.
- C. Use twine to wrap the finger and, when the tissue is compressed, pull the free end of the twine and remove the ring.
- D. Use a tongue blade to remove the ring.
Correct Answer: C
Rationale: If applying soap or oil to the finger proves unsuccessful, the nurse may wrap the finger with twine. Once the tissue is compressed, the ring can be removed by pulling on the free end of the twine. This technique is preferable to damaging the ring with a metal cutter. If nothing else facilitates ring removal, however, cutting the ring is a better option than allowing damage from ischemia to develop. The nurse cannot administer a diuretic without a physician's prescription, and allowing the swelling to go down may cause tissue ischemia from the constricted ring. There are options other than cutting the ring, but if they fail, there is no other choice. A tongue blade will not remove a ring that is too tight.