Allergic Reactions and Anaphylaxis for Certified Emergency Nursing (CEN)
Included In This Lesson
Study Tools For Allergic Reactions and Anaphylaxis for Certified Emergency Nursing (CEN)
Outline
Allergic Reactions and Anaphylaxis:
Definition/Etiology:
We all know that an allergic reaction is a response by the body’s immune system to an exposure to an antigen. The most common ones are antibiotics, insect bites and stings, foods, and environment. The most severe reaction is, of course, anaphylaxis, which can cause complete airway obstruction pretty quickly.
Pathophysiology:
OK so we don’t have the time to go through the full patho of allergic reactions, and frankly, CEN likely will not ask about the patho on this, so just know that allergic reactions are the body’s response to an antigen. The reaction involves IgE cells, T cells, B cells, CD4 cells….a whole bunch of cells that are basically trying to protect the body from a perceived threat. If you want to know more, you can check the article in the reference section.
Clinical Presentation:
- The presentation of these patients can be from mild to severe and we have all seen the spectrum. Any of the following (or frankly all of the following) can be present.
- Flushed skin
- Hives
- Urticaria
- Coughing
- Sneezing
- Dyspnea
- Facial and upper airway edema
- Muffled voice
- Wheezing
- Stridor
- N/V/D
Collaborative Management:
Our treatment here will depend on the severity of the reaction. If someone comes in with some simple hives, they may be discharged just with a prescription and some well wishes. On the other hand, if they are in full blown anaphylaxis, well then, time to go to work!
- Allow positioning for comfort and air exchange
- High flow O2
- IV access (don’t get me started on small gauge)
- Cardiac and O2 sat monitoring
- Grab the emergency airway cart, just in case.
- Prep for intubation
- Anticipate meds:
- Bronchodilators
- Epi – sub-Q for moderate reactions, IV for more severe
- Antihistamines – Benadryl
- H2 blockers – Pepcid
- Corticosteroids
Evaluation | Patient Monitoring | Education:
Our effectiveness of treatment will be determined by the patient’s response. If they are having difficulty breathing…we want them to have less difficulty. If they have hives and urticaria, we want to lessen these symptoms. Honestly, an allergic reaction is one of the conditions where we can see a positive response fairly quickly.
One of the most important things to remember is just because we have resolution of symptoms after our initial treatments, DON’T LET THEM LEAVE. Especially if we are unsure of what triggered the reaction. Usually after symptoms begin to resolve, we want to hold on to these patients for a few hours….why?
That’s right, to make sure the reaction does not rebound when the meds wear off!
As far as education here, it can be difficult if we don’t know what caused the reaction. If we do.. well, it’s fairly simple… stay away from that thing!
Linchpins: (Key Points)
- What?
- Act fast
- Prep for anything
Transcript
For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/
References:
- Emergency Nurses Association. (2022). Emergency Nursing Orientation 3.0. Cambridge, MA: Elsevier, Inc.
- Sheehy, S. B., Hammond, B. B., & Zimmerman, P. G. (2013). Sheehy’s manual of emergency care (Vol. 7th Edition). St. Louis, MO: Elsevier/Mosby.
KRISTELLE
Concepts Covered:
- Cardiac Disorders
- Cardiovascular
- Circulatory System
- Nervous System
- Skeletal System
- Emergency Care of the Cardiac Patient
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Hematology
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Newborn Complications
- Renal
- Respiratory
- Test Taking Strategies
- Note Taking
- Prefixes
- Suffixes
- Medication Administration
- Gastrointestinal Disorders
- Respiratory Disorders
- Respiratory System
- Urinary System
- Pregnancy Risks
- Labor Complications
- Hematologic Disorders
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- Delegation
- Perioperative Nursing Roles
- Lower GI Disorders
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- EENT Disorders
- Central Nervous System Disorders – Brain
- Documentation and Communication
- Preoperative Nursing
- Disorders of the Adrenal Gland
- Disorders of the Thyroid & Parathyroid Glands
- Endocrine System
- Legal and Ethical Issues
- Adult
- Basics of NCLEX
- Communication
- Understanding Society
- Immunological Disorders
- Substance Abuse Disorders
- Studying
- Fetal Development
- Terminology
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Tissues and Glands
- Vascular Disorders
- Eating Disorders
- Microbiology
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Anxiety Disorders
- Depressive Disorders
- Oncology Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Respiratory Emergencies
- Noninfectious Respiratory Disorder
- Basics of Chemistry
- Neurologic and Cognitive Disorders
- Integumentary Disorders
- Newborn Care
- Basics of Mathematics
- Statistics
- Emergency Care of the Trauma Patient
- Hematologic System
- Hematologic Disorders
- Developmental Considerations
- Digestive System
- Behavior
- Postpartum Care
- Basic
- Integumentary Disorders
- Metabolism
- Cardiovascular Disorders
- Concepts of Population Health
- Musculoskeletal Disorders
- EENT Disorders
- Basics of Human Biology
- Postoperative Nursing
- Urinary Disorders
- Neurological Emergencies
- Prenatal Concepts
- Disorders of Thermoregulation
- Community Health Overview
- Neurological Trauma
- Renal Disorders
- Concepts of Mental Health
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Postpartum Complications
- Concepts of Pharmacology
- Integumentary Important Points
- Emotions and Motivation
- Health & Stress
- Multisystem
- Proteins
- Renal and Urinary Disorders
- Developmental Theories
- Reproductive System
- Endocrine and Metabolic Disorders
- Musculoskeletal Disorders
- Adulthood Growth and Development
- Psychological Emergencies
- Growth & Development
- Female Reproductive Disorders
- Basics of Sociology
- Neurological
- Intelligence and Language
- Labor and Delivery
- Reading
- Oncologic Disorders
- Bipolar Disorders
- Med Term Basic
- Peripheral Nervous System Disorders
- Infectious Disease Disorders
- Muscular System
- Central Nervous System Disorders – Spinal Cord
- Learning Pharmacology
- Prioritization
- Somatoform Disorders
- Writing
- Pediatric
- Emergency Care of the Respiratory Patient
- Sensory System
- State of Consciousness