****** please response to each peers answer add citations and references 🙂 ******

Response one Nurses must be aware of the signs and symptoms of anaphylactic shock, a life-threatening allergic reaction requiring an immediate response. Symptoms may include flushing, nausea, vomiting, fever, rash, hives, angioedema, a feeling of impending doom, bronchospasm, back pain, and circulatory collapse (U.S. National Library of Medicine, 2018).

Symptoms of anaphylaxis generally have their onset within minutes, but occasionally occur as late as 1 hour after exposure to the offending antigen. The signs and symptoms may follow a uni-phasic course, with the resolution of symptoms within hours of treatment. Anaphylactic shock must be differentiated from other causes of circulatory collapse. The most common conditions that mimic anaphylaxis are vasovagal reactions, which are characterized by hypotension, pallor, bradycardia, weakness, nausea, vomiting, and diaphoresis. Urticaria, pruritus, angioedema, tachycardia, and bronchospasm are not vasovagal responses. Acute respiratory decompensation from severe asthma attacks, foreign body aspiration, and pulmonary embolism can feature respiratory symptoms suggestive of anaphylaxis, but other characteristics such as; pruritis, urticaria, angioedema are not present (Ellis, 2003).

In the clinical setting, nurses must be aware of signs, symptoms, and the appropriate response should a patient exhibit anaphylactic shock. If a nurse suspects an anaphylactic reaction, immediate steps must be taken. First, stop the administration of any medications and alert the primary physician. Assess the patient’s vital signs, oximetry, and breath sounds. Prepare for emergency response, including administration of oxygen, IV fluids, and resuscitative medications: epinephrine IM or SQ, albuterol inhalant, corticosteroids, and antihistamines (Randall, 2018). Most facilities have specific protocols in place with standing orders for intervention in the event of anaphylaxis. The nurse should be familiar with the organization’s protocols. Patients with known allergies producing anaphylactic response are advised to carry an epi-pen. Nurses should be involved in patient education involving the use and storage of the epi-pen.

References

Ellis, A. K., & Day, J. H. (2003). Diagnosis and management of anaphylaxis. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 169(4), 307–311.

Randall, J. (2018). Cellular and immunological complexities. In GCU (Ed.), Pathophysiology Clinical Applications for Client Health (1 ed.). Retrieved from https://lc.gcumedia.com/nrs410v/pathophysiology-cl…

U.S. National Library of Medicine. (2018). Allergic reactions. Retrieved from https://medlineplus.gov/ency/article/000005.htm

Response two; When exposed to something they are allergic to, people may have a reaction called anaphylaxis and can go into anaphylactic shock is a dangerous condition for a patient to experience if it isn’t treated immediately and can result in serious conditions, if not fatal (Gotter, 2018). When the body goes into anaphylactic shock, their blood pressure drops dramatically and the airways can narrow, possibly blocking a person’s normal breathing (Gotter, 2018).

Symptoms of anaphylaxis may occur before anaphylactic shock happens which include: skin reactions such as hives, flushed skin, or paleness, suddenly feeing too warm, feeling like there is a lump in their throat or difficulty swallowing, nausea, vomiting, diarrhea, abdominal pain, a weak and rapid pulse, runny nose and sneezing, swollen tongue or lips, wheezing or difficulty breathing, a sense that something is wrong with their body, and tingling hands, feet, mouth or scalp (Gotter, 2018). If anaphylaxis has progressed to anaphylactic shock, the symptoms include struggling to breathe, dizziness, confusion, sudden feeling of weakness and loss of consciousness (Gotter, 2018). Risk factors for severe anaphylaxis and anaphylactic shock include a previous anaphylactic reaction, allergies or asthma, and a family history of anaphylaxis (Gotter, 2018).

If a nurse suspects anaphylactic shock, it should be treated immediately because if it is not, more invasive procedures will have to be taken in order for the patient to survive. A nurse must know the signs and symptoms of anaphylaxis and anaphylactic shock which include looking at the respiratory signs, skin manifestations, cardiovascular manifestations, and gastrointestinal problems. Establishing a patient airway and ventilation is important along with epinephrine if needed. Additional treatments may include, antihistamines, aminophylline titrated by IV drip, albuterol, crystalloids, colloids, vasopressors, IV benzodiazepines. After the acute symptoms have been treated, the patient is usually admitted for observation and are educated about how to prevent future anaphylactic reactions.

References

Gotter, A. (2018, April 26). Anaphylactic Shock: Symptoms, Causes, Risks, Treatments & More. Retrieved from https://www.healthline.com/health/anaphylactic-sho…

RESPONSE THREE; Anaphylactic shock is a life-threatening allergic reaction that requires immediate response. Some of the most common antigens that are associated with anaphylactic shock include certain foods, such as peanuts, tree nuts, dairy, eggs, and shellfish; environmental allergens, including mold, pollen, venom from insect stings; and certain medications (Randall, 2018). Symptoms may include flushing, nausea, vomiting, fever, rash, hives, angioedema, feelings of impending doom, bronchospasm, back pain, and circulatory collapse (Randall, 2018).

Nurses must take immediate steps when anaphylaxis is suspected . First step is to stop administration of any medications and alert the physician (Randall, 2018). The nurse must then assess the patient’s vital signs, oximetry, and breath sounds (Randall, 2018). Prepare for emergency response, including administration of oxygen, IV fluids, and resuscitative medications: epinephrine IM or SQ, albuterol inhalant, corticosteroids, and antihistamines (Randall, 2018). Nurses must know the protocols in place for the company they work for. Not every facility is the same. For example, my dialysis clinc does not have the emergency medications other than the epi-pen and diphenhydramine to treat an allergic reaction. No other medication is available to treat emergencies, we must call EMS.

Randall, J. (2018). Cellular and immunological complexities. In GCU (Ed.), Pathophysiology Clinical Applications for Client Health (1 ed.). Retrieved from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/4