Allergy & Anaphylaxis Flashcards by Kay H

The study of the body’s immune system

Immunology

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Protects the human body from foreign substances and organisms

Immune system

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Exaggerated immune response to any substance

Allergic reaction

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Common chemicals released by body to combat a stimulus

Histamines and leukotrienes

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The first time someone is exposed to an allergen they are ___

Sensitized

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An extreme allergic reaction that is life threatening and involves multiple organ systems

Anaphylaxis

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Two most common signs of anaphylaxis

Urticaria
Angioedema

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Small areas of generalized itching or burning that appear as multiple small, raised areas on the skin

Urticaria (hives)

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Areas of localized swelling

Angioedema

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High-pitched whistling breath sound that is typically heard on expiration

Wheezing

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Wheezing from anaphylaxis is usually caused by ___

Bronchospasm/bronchoconstriction and increased mucus production

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Signs of possible upper airway narrowing

Voice changes and stridor

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High-pitched respiratory sound that is usually hear on inspiration

Stridor

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During anaphylaxis, you may note hypotension due to ___

Vasodilation

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During anaphylaxis, you may note increased ___, causing fluid from the bloodstream to seep into the tissues

Capillary permeability

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One symptom that is often overlooked in anaphylaxis patients

Gastrointestinal dysfunction

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Five general categories of allergens

Food
Medication
Plants
Chemicals
Insect bites and stings

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Food allergy symptoms may take more than ___ to appear

30 minutes

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Food allergy symptoms may not include ___

Skin signs

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Common symptom of food allergy

Abdominal cramping, vomiting, & diarrhea

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Most common source of anaphylaxis

Food allergy

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Second most common source of anaphylaxis

Medication

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Most common medication types to cause anaphylaxis

Antibiotics and NSAIDs

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If medication is ___, the reaction may be immediate

Injected

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An immediate reaction is within ___

30 minutes

Common plant allergens

Ragweed, ryegrass, maple, and oak

Common chemical allergen that affects health care

Latex

The act of injecting venom

Envenomation

If a bee stinger is not removed it can continue to inject venom fro up to ___

20 minutes

A harmful substance produced by living cells or organisms

Toxin

Signs and symptoms of insect stings and bites

1. Sudden pain 2. Swelling 3. Localized heat 4. Widespread urticaria 5. Redness in light-skinned people May be: 6. Itching 7. Wheal

A raised, swollen, well-defined area on the skin

Wheal

Signs and symptoms of insect stings and bites in anaphylactic patients

1. Stridor 2. Bronchospasm 3. Wheezing 4. Chest tightness 5. Coughing 6. Dyspnea 7. Anxiety 8. GI complaints 9. Hypotension 10. Respiratory failure 11. Confusion

Allergic reactions may present as ___ distress or as ___ distress in the form of shock

1. Respiratory 2. Cardiovascular

If your general impression finds the person anxious and in distress, ___

Immediately call for ALS backup

Most severe form of allergic reaction

Anaphylaxis

Anaphylaxis can cause rapid swelling of the ___

Upper airway

Can provide clues as to an allergy in a patient who cannot tell you

Medical identification tag

Signs of impending airway obstruction

1. Swollen lips or tongue 2. Hoarseness 3. Stridor

Dyspnea may present with ___

1. Increased work of breathing 2. Use of accessory muscles 3. Head bobbing 4. Tripod positioning 5. Nostril flaring 6. Abnormal breath sounds

Wheezing occurs because of ___

Narrowing of the lower air passages

Narrowing of the lower air passages is mainly the result of ___

Contraction of muscles around the bronchioles in reaction to the allergen, and mobilization of mucus in an attempt to push out the allergen

Stridor occurs when ___

Swelling in the upper airway begins to close off the airway

Generally the best position for a patient with breathing distress from an allergic reaction

Fowler position

If a patient develops signs of shock, they should be placed in the ___ position

Supine

Positive pressure ventilations will force air beyond ___

The selling in the airway and into the lungs while you wait for more definitive treatment

Not all patients with anaphylaxis will present with respiratory distress, some will present with ___ such as ___

1. Circulatory distress 2. Hyptension

How to determine if patient is in circulatory distress quickly

Palpating for the presence and quality of a radial pulse

If anaphylaxis is suspected, or if a relatively mild allergic reaction appears to be worsening, ___

Immediate transport is warranted after epinephrine is given

Before leaving the scene of anaphylaxis, be sure to take along the patient's ___

Medications

History taking questions specific to an allergic reaction

1. Have any interventions already been completed? 2. Has the patient experienced a severe allergic reaction in the past? 3. Be alert for any statements regarding the ingestion of foods that commonly cause allergic reactions

Respiratory signs and symptoms of an allergic reaction

1. Sneezing or an itchy, runny nose (early sign) 2. Dyspnea 3. Tightness in the chest or throat 4. Irritating, persistent dry cough 5. Hoarseness 6. Rapid, labored, or noisy respirations 7. Wheezing and/or stridor (may progress to a silent chest as a late sign)

Cardiovascular signs and symptoms of an allergic reaction

1. Tachycardia (early sign) 2. Red, flushed, hot skin (early sign) or pale, cyanotic, cook skin (late sign) as the vascular system fails 3. Hypotension (late sign) as the blood vessels dilate

Skin signs and symptoms of an allergic reaction

1. Flushing, itching, or burning skin, common over the face and chest 2. Urticaria over large areas of the body (internal or external) 3. Swelling, especially of the face, neck, hands, feet, and/or tongue, either local (angioedema) or generalized 4. Cyanosis or pallor around the lips 5. Warm, tingling feeling in the face, mouth, chest, feet, and hands

Other signs and symptoms of an allergic reaction

1. Decreasing mental status (early sign of hypoperfusion), from mild confusion or lethargy to loss of consciousness or coma 2. Anxiety, sense of impending doom 3. Gastrointestinal problems, including nausea, vomiting, or abdominal cramps 4. Headache 5. Itchy, watery eyes 6. Dizziness

If a patient with an allergic reaction is unconscious for the secondary assessment, remove clothing as necessary and observe for ___

Presence of bee stingers, signs of contact with chemicals, and other clues suggestive of a reaction. Look for a medical alert tag

How to remove an insect stinger

Scrape the skin with the edge of a sharp, stiff object like a credit card

After removing an insect stinger ___

Gently wash the area with soap and water or mild antiseptic

Position the patient with the insect stinger injection site positioned ___

Slightly below the level of the heart, and apply ice or cold packs to the area

Epinephrine is a ___

Sympathomimetic hormone

Mimics the sympathetic response

Epinephrine causes blood vessels to ___

Constrict

Epinephrine comes in two common forms

EpiPen Auvi-Q

Auvi-Q comes in a third dose of ___ for those patients weighing ___

0.1 mg 17 to 33 lbs

The adult EpiPen delivers ___ of epinephrine

0.3 mg

The EpiPen Jr for infants/children delivers ___ of epinephrine

0.15 mg

How long to hold the EpiPen in place

3 seconds

After injecting the EpiPen, rub the area for ___

10 seconds

If the patient's condition does not improve after ___, consider using another EpiPen

5 minutes

Indications for epinephrine

Severe allergic reaction causing airway, breathing, or circulatory compromise or an anaphylactic reaction

Contraindications for epinephrine

None in a life-threatening emergency; however consult medical control when the patient has a history of heart disease or acute coronary syndrome

Actions of epinephrine

Vasoconstriction and increased cardiac contractility, bronchodilation

Side effects of epinephrine

Tachycardia, sweating, pale skin, dizziness, headache, palpitations

An adult EpiPen can be used for a patient weighing over ___

66 lbs

Patients weighing less than ___ will have to be dosed individually for epinephrine

33 lbs

Epinephrine concentration for IM injection

1 mg/mL

Allergy & Anaphylaxis Flashcards

(76 cards)