Allergies/Transfusion/Anaphylaxis Flashcards

Question

Cimetedine (Tagamet)

Answer 1

Drug classes: histamine2 antagonist Therapeutic actions: inhibits the action of histamine Adverse effects: dizziness, somnolence, headache, confusion, hallucinations, diarrhea Nursing: Monitor side effects

Answer 2

``` Monitor vital signs respiratory effort O2 sat cardiac rhythm LOC Anticipate intubation or tracheostomy if severe laryngeal edema ```

Answer 3

Epinephrine (.3mg) to be injected by self or other in case of a severe allergic reaction. Used by or for a person that is well known to suffer from an anaphylactic allergy to a specific substance.

Answer 4

- Anaphylactic allergen is written in red on the chart of the patient - Patient should wear a medic-alert bracelet - Patient should carry an epipen at all times - Should be offered immunotherapy, especially if allergen is insect bites

Answer 5

individuals with anaphylactic reaction to insect venom or when allergen can’t be avoided and drug therapy is not effective.

Answer 6

- To keep high levels of “blocking” IgG levels | - To help individual develop allergen-specific T suppressor cells

Answer 7

- sub-cutaneous injection twice or once a week - dose of allergen increasing gradually - takes about two years to reach the maximum therapeutic effect - could last up to 5 years or indefinitely with severe allergies or insect stings

Answer 8

``` ALLERGIC RHINITIS (HAY FEVER) ASTHMA ATOPIC DERMATITIS URTICARIA (HIVES) ANGIOEDEMA ```

Answer 9

- Most common type 1 hypersensitivity reaction. - Seasonal or year round (perennial allergic rhinitis) - Principal causes: pollen, dust, molds, animal dander, weeds and grass

Answer 10

``` Nasal discharge Sneezing Lacrimation Mucosal swelling and airway obstruction Pruritus around eyes, nose, throat and mouth ```

Answer 11

- bronchial smooth muscle constriction - excessive secretion of viscoid mucus - edema of mucus membranes of bronchi - decreased lung compliance

Answer 12

``` Dyspnea Wheezing Coughing Chest tightness Thick sputum ```

Answer 13

CHARACTERISTIC: exacerbation and remission PRESENTATION: - skin lesions are generalized - involve vasodilation of blood vessels - vesicle formation - erythema, crust and cracks

Answer 14

``` PRESENTATION: -transient wheals (pink, raised, edematous, pruritic areas) -is localized -develops shortly after exposure -could last minutes or hours ```

Answer 15

PRESENTATION: - lesions similar to urticaria but deeper in the skin, and mucosa layers - diffuse swelling; no welts; the outer skin appears normal or reddish - swelling starts in the face and then progresses to the airway and other parts of the body AREAS INVOLVED: Eyelids, lips, tongue, larynx, hand, feet and GI SENSATION: Burns, stings, slight itch and abdominal pain REACTION: Swelling might occur suddenly or over a few hours and could last for 24 hrs

Answer 16

SAME AS CELL-MEDIATED IMMUNE RESPONSE Tissue damage caused by T lymphocytes and macrophages. Reaction takes between 24-48hrs Includes: - contact dermatitis - hypersensitivity reactions to bacterial, fungal and viral infections and transplant rejections

Answer 17

When skin is exposed to a certain substance that becomes antigenic over a period of 7-14 days (the memory cells from the antigen) On subsequent exposures to the substance, a sensitized person develops eczematous skin lesions within 48 hrs. PRESENTATION: - skin appears erythematous and edematous - papules, vesicles and bullae - may burn, itch or sting - is localized and restricted to the area exposed to allergen CAUSES: metal compounds, rubber compounds, poison ivy, poison oak and sumac, cosmetics, some dyes

Answer 18

-Use non-latex gloves if not in contact with infectious material -Use powder-free gloves -Do not use oil-based hand cream or lotions when wearing gloves -Wash hands with soap after removing gloves medic-alert bracelet and Epipen if severe allergy

Answer 19

TUBERCULOSIS IS AN EXAMPLE PPD skin test will read positive after 48-72hrs. after injection because the initial cell-mediated reaction, memory cells remain

Answer 20

- Linked to various chemicals and food in the environment - Subjective symptoms related to multiple body systems: fatigue, headache, nausea, pain, dizziness, mouth irritation, disorientation and cough. - Primarily in women - Odour is principle trigger

Answer 21

Hyperacute Acute Chronic IMMUNOSUPPRESSIVE THERAPY FOR LIFE

Answer 22

``` HEALTH HISTORY Family allergies Past and present allergies Clinical manifestations and course of allergic reactions Social and environmental factors ``` PHYSICAL EXAMINATION ``` SUBJECTIVE DATA: FUNCTIONNAL HEALTH PATTERNS -health perception and health management -nutrition; elimination -activity and exercises -cognitive and perceptual (ex itching) -role and relationship (ex home-work) ``` ``` OBJECTIVE DATA: RASHES EYES-EARS AND THROAT RESPIRATORY POSSIBLE FINDINGS (blood test, skin tests) ```

Answer 23

CBC with differential -with immunodeficieny lymph count will be lower than 1200 µ, eosinophil count is higher than normal Immunoglobulins - Sputum, nasal and bronchial cultures - Pulmonary functions for asthma - Skin testing - Alpha-1 Antitrypsin

Answer 24

CHARACTERISTIC: Remission and exacerbation of symptoms TREATMENT: Allergen recognition and control -decrease exposure to offending allergen -treat the symptoms -talk to patient of having a safer environment -teach patient relaxing techniques and stress management

Answer 25

- For treatment of allergic rhinitis and urticaria | - Best results if taken as soon as allergy signs and symptoms appear

Answer 26

- Epinephrine or adrenaline | - Sudafed (orally or nasally; used for allergic rhinitis and could last hours.)

Answer 27

- nasal spray for rhinitis (Nasonex) | - oral cortisone to relieve severe discomfort of allergies

Answer 28

- Calamine lotion - benadryl ointment - coal tar solution (ex Tegrin shampoo) - camphor

Answer 29

Involves the direct binding of antibodies to an antigen on the cell surface Antigen-antibody will create a reaction that will destroy cellular tissue by: -cytolysis -phagocytosis Target cells frequently destroyed are: erythrocytes, platelets and leucocytes Antigen involved are ABO, Rh and drugs

Answer 30

Blood group antigens (A & B) are found only on RBCs membranes ABO INCOMPATIBILITY

Answer 31

Antibodies on the recipient’s serum react with antigens on the donor’s RBCs. Results in agglutination of cells which can obstruct capillaries and block blood flow Hemolysis of the RBCs releases free hemoglobin into the plasma The hemoglobin is filtered by the kidney and may be found in urine and may obstruct the renal tubules The clinical reactions may be mild or severe Usually develop within the first 15 minutes of transfusion

Answer 32

Most common -due to the sensitization of the patient to the WBCs of the donor (leucocytes) - S&S: sudden chills and fever (+1C), flushing, anxiety, muscle pain and vomiting - Management: Stop transfusion, call md and give antipyretics

Answer 33

- Due to patient`s sensitivity to plasma proteins of the donor`s blood. - Most common with patients who have hx of allergies - S&S: mild-flushing, itching, hives - Management: stop transfusion. If mild symptoms, give patient antihistamine (as ordered) and restart transfusion slowly. If severe, discontinue.

Answer 34

-In patients with cardiac or renal insufficiency -S&S: cough, dyspnea, pulmonary congestion, hypertension, tachycardia, distended neck veins -Management: stop infusion, place patient upright with feet in dependant position, give diuretics and O2 as ordered

Answer 35

- Due to blood products becoming infected from improper handling and storage - S&S: rapid onset of chills, high fever, vomiting, diarrhea, marked hypotension or shock - Management: stop transfusion, obtain blood cultures and send bag with remaining blood and all tubing back to blood bank

Answer 36

- Can occur 2-14 days after the administration of blood - Include delayed hemolytic transfusion reactions (fever, mild jaundice, decreased hematocrit) - No acute treatment is required but must be taken into consideration for further transfusions- notify MD

Answer 37

- Use an 18 gage needle preferably - Maximum infusing time for blood product is 4 hours - Has to be administered within 30 min. after the product gets to the unit - Must be given in conjunction with Normal Saline only with a Y connection - Do not use the transfusion line to administer medications - Use an IV line specific for blood products (has a filter integrated)

Answer 38

-When the blood product is delivered to the unit, two nurses must make positive identification of the blood donor AND the recipient -Inspect blood or blood component (visually) -Nurse must verify patient understanding of procedure and S&S to report as well has obtaining a signed consent Nurse take VS before transfusion and reports abnormalities (esp. hyperthermia) -Nurse remains at the patient’s bedside for the first 15 min. or 50ml of the transfusion for safety measure (transfusion reaction) rate 2ml/min. -After 15 min. or 50ml of blood infusion, VS are taken again and rate of infusion is governed by the clinical condition of the patient and the product being infused

Answer 39

-Stop transfusion -Keep main IV line open with Normal Saline (different line than blood set) -Take vital signs and monitor urine output -Notify blood band and MD immediately- anticipate possible orders -Check concordance of information on label, voucher and patient`s ID band -If transfusion is discontinued, send blood bag with tubing, blood specimen and reaction report to the blood bank Send blood for C&S in the presence of fever, chills, dyspnea or hypotension -Inform blood bank if symptoms persist or worsen -Document the reaction in patient’s chart in RED

Allergies/Transfusion/Anaphylaxis Flashcards

(63 cards)