Discussion: Type of altered immune response

B.N., a 41-year-old female who is a dental hygienist, has had several surgeries over the past five years due to a knee injury. She presents to the outpatient surgery department today for her last reconstructive surgery. Her past medical history indicates she had asthma as a child and had one occurrence of contact dermatitis. She tells you she has no known drug allergies.

You start B.N.’s IV and perform a saline flush. Within three minutes, B.N. states that her IV site itches, and a few minutes later she begins to complain of tightness in her throat.

Subjective Data

• States IV site itches • States throat and neck feel tight and says ‘I feel like I can’t breathe’

Objective Data

• Vital signs: Temp 98.8° F, Heart rate 120, Respiratory rate 32, Blood pressure 100/60 • Oxygen saturation 85% • Wheezing in all lung fields • Restless • Swelling at IV site

I. Question 1

What type of altered immune response is B.N. experiencing?

II. Question 2

What is the apparent causative factor and what were potential sources of exposure?

III. Question 3

What are the priority nursing interventions in this situation? What medications might you expect the health care provider to prescribe?

IV. Question 4

What were B.N.’s risk factors for this type of reaction?

V. Question 5

Based on this reaction, to what foods should B.N. be tested for allergies?

VI. Question 6

How can such reactions be prevented from occurring?

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