A nurse has asked the nurse educator if there is any way to predict the severity of a patients anaphylactic reaction. What would be the nurses best response?
- A. The faster the onset of symptoms, the more severe the reaction.
- B. The reaction will be about one-third more severe than the patients last reaction to the same antigen.
- C. There is no way to gauge the severity of a patients anaphylaxis, even if it has occurred repeatedly in the past.
- D. The reaction will generally be slightly less severe than the last reaction to the same antigen.
Correct Answer: A
Rationale: The time from exposure to the antigen to onset of symptoms is a good indicator of the severity of the reaction: the faster the onset, the more severe the reaction. None of the other statements is an accurate description of the course of anaphylactic reactions.
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A patient has presented with signs and symptoms that are consistent with contact dermatitis. What aspect of care should the nurse prioritize when working with this patient?
- A. Promoting adequate perfusion in affected regions
- B. Promoting safe use of topical antihistamines
- C. Identifying the offending agent, if possible
- D. Teaching the patient to safely use an EpiPen
Correct Answer: C
Rationale: Identifying the offending agent is a priority in the care of a patient with dermatitis. Antihistamines are not administered topically and epinephrine is not used to treat dermatitis. Inadequate perfusion occurs with PAD or vasoconstriction.
A patient was prescribed an oral antibiotic for the treatment of sinusitis. The patient has now stopped, stating she developed a rash shortly after taking the first dose of the drug. What is the nurses most appropriate response?
- A. Encourage the woman to continue with the medication while monitoring her skin condition closely.
- B. Refer the woman to her primary care provider to have the medication changed.
- C. Arrange for the woman to go to the nearest emergency department.
- D. Encourage the woman to take an OTC antihistamine with each dose of the antibiotic.
Correct Answer: B
Rationale: On discovery of a medication allergy, patients are warned that they have a hypersensitivity to a particular medication and are advised not to take it again. As a result, the patient would need to liaise with the primary care provider. There is no need for emergency care unless symptoms worsen to involve respiratory function. An antihistamine would not be an adequate or appropriate recommendation from the nurse.
A nurse is preparing a patient for allergy skin testing. Which of the following precautionary steps is most important for the nurse to follow?
- A. The patient must not have received an immunization within 7 days.
- B. The nurse should administer albuterol 30 to 45 minutes prior to the test.
- C. Prophylactic epinephrine should be administered before the test.
- D. Emergency equipment should be readily available.
Correct Answer: D
Rationale: Emergency equipment must be readily available during testing to treat anaphylaxis. Immunizations do not contraindicate testing. Neither epinephrine nor albuterol is given prior to testing.
An adolescent patients history of skin hyperreactivity and inflammation has been attributed to atopic dermatitis. The nurse should recognize that this patient consequently faces an increased risk of what health problem?
- A. Bronchitis
- B. Systemic lupus erythematosus (SLE)
- C. Rheumatoid arthritis
- D. Asthma
Correct Answer: D
Rationale: Nurses should be aware that atopic dermatitis is often the first step in a process that leads to asthma and allergic rhinitis. It is not linked as closely to bronchitis, SLE, and RA.
The nurse is creating a care plan for a patient suffering from allergic rhinitis. Which of the following outcomes should the nurse identify?
- A. Appropriate use of prophylactic antibiotics
- B. Safe injection of corticosteroids
- C. Improved skin integrity
- D. Improved coping with lifestyle modifications
Correct Answer: D
Rationale: The goals for the patient with allergies may include restoration of normal breathing pattern, increased knowledge about the causes and control of allergic symptoms, improved coping with alterations and modifications, and absence of complications. Antibiotics are not used to treat allergies and corticosteroids, if needed, are not administered parenterally. Allergies do not normally threaten skin integrity.
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