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Shock > Anaphylactic Shock > Flashcards

Anaphylactic Shock Flashcards

1
Q

Patho

A

Severe systemic hypersensitivity reaction to a specific antigen
Allergic reaction results in histamine secretion & severe widespread vasodilation.
Affects Pulmonary, Circulatory & Integumentary Systems
Results in: Systemic vasodilation causing
Smooth muscle contraction (airway)

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2
Q

Triggers

A

Seafood and Antibiotics

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3
Q

Smooth muscle contraction causes

A

Circulatory collapse
Airway compromise: R/T smooth muscle contraction
Bronchoconstriction: R/T smooth muscle contraction
Increased mucus production
Result: Respiratory Insufficiency

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4
Q

What is different about anaphylactic shock

A

Causes smooth muscle contraction (airway)

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5
Q

Onset

A

Sudden with rapid progression

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6
Q

Systems Affected

A

Pulmonary
Circulatory

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7
Q

Pulmonary symptoms

A

Laryngeal edema
Shortness of breath
Tachypnea
Wheezing
Stridor
Cyanosis
Cough, Rhonchi
Nasal congestion
Angioedema

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8
Q

Circulatory symptoms

A

Tachycardia
Hypotension
Weak pulses
Cool, pale, clammy skin AND Flushing, red raised rash, or angioedema
Syncope
Lightheaded
Arrythmias

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9
Q

What causes cool, pale, clammy skin

A

decreased CO

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10
Q

How can skin issues be resolved in anaphylactic shock?

A

antihistamines or epi

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11
Q

Most concerning s/s

A

pulmonary related

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12
Q

What is the cause of pulmonary symptoms

A

contraction of the smooth muscles in the airways

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13
Q

Integumentary Effects

A

Tingling
Warmth
Diffuse redness, flushing.
Urticaria
Pruritus
Angioedema
Swelling around the eyes
Cool, clammy skin R/T decreased CO

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14
Q

Urticaria

A

itchy red raised rash.

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15
Q

Causes

A

Blood products
IV contrast dye
Medications
Food
Exercise

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16
Q

Medication that can trigger anaphylactic shock

A

Antibiotics
Opiates
ASA, NSAIDs
ACE Inhibitors (dialysis patients)
Anesthetics
Egg-based vaccines

17
Q

What medication can you give if a pt is allergic to ACE inhibitors

A

ARBs

18
Q

Food triggers

A

Nuts, seafood, eggs, tropical fruits.

19
Q

Cross contamination

A

Cross reactions (ex: seafood-iodine)
Venom, latex, glue

20
Q

Management

A

Remove/stop the cause/trigger
100% NRBM and possible intubation
IV Therapy
Address the primary issue

21
Q

Step 1 management

A

Remove/stop the cause/trigger

22
Q

Step 2 management

A

100% NRBM (ABCs) then possible intubation
Support vital functions.
Intubation
IV fluids

23
Q

Step 3 Management

A

IV therapy: Epinephrine 1st line therapy 0.3 ml (1:1000 conc.)
Can be given IM in an emergency (EPI JET)
Cardiopulmonary resuscitation

24
Q

Epinephrine 1st line therapy dosage

A

0.3 ml (1:1000 conc.)

25
Q

Primary issues

A

Bronchoconstriction: nebulizer treatment
Vasodilation: vasopressor
Vascular permeability

26
Q

Medications to Manage Anaphylactic Shock

A

Epinephrine
Antihistamines IVP
Corticosteroids
Nebulizer treatment (bronchodilators)

27
Q

Epinephrine

A

(1:1,000 concentration)
Alpha & beta receptor properties for vasoconstriction

28
Q

Alpha & beta receptor properties for vasoconstriction
Alpha 1= vasoconstrictor
Beta 2 = bronchodilator (dilates constricted bronchioles)

A

Alpha 1= vasoconstrictor
Beta 2 = bronchodilator (dilates constricted bronchioles)

29
Q

Antihistamines IVP

A

Block histamine secretion

30
Q

Corticosteroids

A

Reduces release of chemical mediators

31
Q

Nebulizer Treatment

A

Bronchodilator
Albuterol: for bronchospasms & wheezing
Racemic epinephrine: for stridor via nebulizer:

32
Q

Nursing Care

A

Prevention
Assessment & Update Pt. allergy record
Identify “at risk” patients.
Early recognition of reactions
Awareness of triggers
Patient education
Ensure all allergies are assessed and updated!
Be sure to ask type of reaction pts experience from allergies.

33
Q

Patient Education

A

Prevention
Preparedness: Epi Pen
Allergy bracelet

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