Transcript anaphylacticreaction..

ANAPHYLACTIC
REACTION
ANAPHYLACTIC SHOCK
• DEFINED: Acute systemic
hypersensitivity reaction that occurs
within seconds to minutes after
exposure to a variety of foreign
substances
• SUCH AS: medications (penicillin,
IVP dye), stinging insects
• CAUSED BY: an antigen antibody
response
Clinical manifestations
• Wide range of clinical manifestations
SKIN MANIFESTATIONS
• flushing,
• sense of warmth,
• diffuse erythema,
• generalized itching,
• uriticaria (hives),
• facial angioedema
• leading to respiratory edema
RESPIRATORY SIGNS
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nasal congestion,
itching,
sneezing,
coughing,
bronchospasm,
edema of the larynx,
tightness of the chest,
wheezing, dyspnea, cyanosis
CARDIOVASCULAR
• Tachycardia
• Bradycardia
• PERIPHERAL VASCULAR COLLAPSE:
pallor, imperceptible pulse,
decreasing BP, circulatory failure
leading to coma, death
PREVENTION
• Determine what patient allergic too
through sensitivity testing via
allergist
• Wear medic alert bracelet
• Carry epi-pen, check expiration date
GASTROINTESTINAL
• Nausea, vomiting, colicky abdominal
pains or diarrhea
NURSING DIAGNOSIS
• Decreased cardiac output
• Impaired gas exchange
• Risk for fluid volume deficit
• Anxiety
EMERGENCY MANAGEMENT
• Establish an airway while another
person gives epinephrine; administer
oxygen
• Epinephrine SQ or IV provides rapid
relief of hypersensitivity reaction and
may be repeated
• EPINEPHRINE: given to restore
vascular tone and raise arterial BP;
vasoconstricts
• DOSE: 1:1000 sol (0.3ml SQ q 5-15
min)
EMERGENCY TX
CONTINUED
• Remove the antigen (blood, penicillin
IV, or other antibiotic)
• Benadryl IV push – antihistamine
effect, reverses histamine effects
(vaso-dilation and bronchoconstriction)
• Solu-Medrol IVPB as an antiinflammatory
• Pepcid IVPB to prevent gastric
irritation from steroids
EMERGENCY TX
CONTINUED
• Check if patient is on betaadrenergic blocking drugs such as
Inderal;
• These drugs decrease the
effectiveness of the epinephrine
• Patient may have a recurrence of
symptoms 6-8 hours after initial
anaphylactic reaction