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ogilusin ogilusin
wrote...
Posts: 587
Rep: 3 0
6 years ago
A client in the family practice clinic reports a 2-week history of an allergy to something. The nurse obtains the following assessment and laboratory data:
 
  Physical Assessment Data
  Laboratory Results
  Reports sore throat, runny nose, headache
  Posterior pharynx is reddened
  Nasal discharge is seen in the back of the throat
  Nasal discharge is creamy yellow in color
  Temperature 100.2  F (37.9  C)
  Red, watery eyes
  White blood cell count: 13,400/mm3
  Eosinophil count: 11.5
  Neutrophil count: 82
  About what medications and interventions does the nurse plan to teach this client? (Select all that apply.)
  a.
  Elimination of any pets
  b.
  Chlorpheniramine (Chlor-Trimaton)
  c.
  Future allergy scratch testing
  d.
  Proper use of decongestant nose sprays
  e.
  Taking the full dose of antibiotics

Question 2

The nursing student is studying hypersensitivity reactions. Which reactions are correctly matched with their hypersensitivity types? (Select all that apply.)
 
  a. Type I - Examples include hay fever and anaphylaxis
  b. Type II - Mediated by action of immunoglobulin M (IgM)
  c. Type III - Immune complex deposits in blood vessel walls
  d. Type IV - Examples are poison ivy and transplant rejection
  e. Type V - Examples include a positive tuberculosis test and sarcoidosis

Question 3

A client having severe allergy symptoms has received several doses of IV antihistamines. What action by the nurse is most important?
 
  a. Assess the client's bedside glucose reading.
  b. Instruct the client not to get up without help.
  c. Monitor the client frequently for tachycardia. d.
  Record the client's intake, output, and weight.
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Replies
wrote...
6 years ago
The answer to question 1

ANS: B, C, D, E
This client has manifestations of both allergic rhinitis and an overlying infection (probably sinus, as evidenced by purulent nasal drainage, high white blood cells, and high neutrophils). The client needs education on antihistamines such as chlorpheniramine, future allergy testing, the proper way to use decongestant nasal sprays, and ensuring that the full dose of antibiotics is taken. Since the nurse does not yet know what the client is allergic to, advising him or her to get rid of pets is premature.

The answer to question 2

ANS: A, C, D
Type I reactions are mediated by immunoglobulin E (IgE) and include hay fever, anaphylaxis, and allergic asthma. Type III reactions consist of immune complexes that form and deposit in the walls of blood vessels. Type IV reactions include responses to poison ivy exposure, positive tuberculosis tests, and graft rejection. Type II reactions are mediated by immunoglobulin G, not IgM. Type V reactions include Graves' disease and B-cell gammopathies.

The answer to question 3

ANS: B
Antihistamines can cause drowsiness, so for the client's safety, he or she should be instructed to call for assistance prior to trying to get up. Hyperglycemia and tachycardia are side effects of sympathomimetics. Fluid and sodium retention are side effects of corticosteroids.
ogilusin Author
wrote...
6 years ago
Now I'm convinced to ask more questions Slight Smile
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