Management of Patients with Allergic Disorders

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Questions and Answers

What characterizes anaphylactic (Type I) hypersensitivity?

Only affects the gastrointestinal tract

Severe rapid reaction with multiple tissue edema (correct)

Involves immune complex deposition in tissues

Slow onset with delayed symptoms

What is the role of primary chemical mediators in Type I hypersensitivity?

To trigger delayed immune responses

To assist in the buildup of antibodies

To induce chronic inflammation over time

To cause symptoms affecting skin, lungs, and GI tract (correct)

Which type of hypersensitivity involves the mistaken identification of the body's own constituents as foreign?

Type I Hypersensitivity

Type III Hypersensitivity

Type IV Hypersensitivity

Type II Hypersensitivity (correct)

Delayed-type hypersensitivity is primarily mediated by which cells?

Sensitized T cells Signup and view all the answers

What distinguishes cytotoxic (Type II) hypersensitivity from other types?

It involves antibody-mediated destruction of cells Signup and view all the answers

How does immune complex (Type III) hypersensitivity lead to tissue injury?

By increasing vascular permeability through complex deposition Signup and view all the answers

Which statement accurately describes the onset of hypersensitivity reactions?

Type I hypersensitivity reactions are immediate following re-exposure Signup and view all the answers

What factor does NOT influence the symptoms experienced during a Type I hypersensitivity reaction?

Type of allergen Signup and view all the answers

What is the recommended timing for administering meclizine for motion sickness?

1 hour before or 2 hours after meals Signup and view all the answers

Which symptom is commonly associated with anaphylaxis?

Generalized itching or tingling sensation Signup and view all the answers

What percentage of eosinophils typically indicates a non-specific allergic reaction?

Between 5% and 15% Signup and view all the answers

What does a high level of total serum IgE indicate?

Allergic disease Signup and view all the answers

What should be done immediately when anaphylaxis occurs?

Administer an epinephrine injection Signup and view all the answers

How can dry mouth associated with medication be alleviated?

Using sugarless candies or lozenges Signup and view all the answers

Which antihistamine is classified as a first-generation drug?

Diphenhydramine Signup and view all the answers

What is the primary cause of anaphylaxis?

Administration of penicillin or exposure to latex Signup and view all the answers

What is the primary action of antihistamines in allergic reactions?

Block the release of histamine Signup and view all the answers

Which type of test involves injecting solutions at several sites to diagnose allergies?

Skin Tests Signup and view all the answers

Which management strategy is NOT effective for severe allergic reactions?

Taking over-the-counter pain relievers Signup and view all the answers

Which receptor is mainly associated with allergic reactions in extravascular smooth muscles?

H1 receptor Signup and view all the answers

What might indicate the severity of anaphylactic symptoms?

Presence of hives and edema Signup and view all the answers

What condition is NOT treated with antihistamines?

Hypertension Signup and view all the answers

What is a recommended nursing intervention to prevent skin breakdown?

Increase fluid intake Signup and view all the answers

Which of the following statements is true regarding second-generation antihistamines?

They have fewer anticholinergic effects. Signup and view all the answers

What is the primary purpose of desensitization treatments in allergic responses?

To create blocking antibodies against the antigen Signup and view all the answers

Which of the following actions is MOST critical in treating anaphylaxis?

Injecting epinephrine immediately Signup and view all the answers

What characterizes the rash resulting from contact dermatitis?

It often presents as a pruritic and edematous area Signup and view all the answers

Which skin disorder is characterized by chronic inflammation and hyperreactivity, commonly known as atopic eczema?

Atopic dermatitis Signup and view all the answers

Which is a common manifestation of allergic dermatitis?

Swelling and presence of small vesicles Signup and view all the answers

What is a typical sign of sensitization upon first exposure to an allergen in type IV hypersensitivity?

Pruritic rash developing a few hours later Signup and view all the answers

In the management of allergic dermatitis, what is the most effective initial step?

Removing the irritant as soon as possible Signup and view all the answers

In patients with atopic dermatitis, which lab finding is most associated with the allergic nature of the condition?

Increased serum IgE levels Signup and view all the answers

What is a common symptom associated with dermatitis?

Dry and scaling skin Signup and view all the answers

Which of the following treatments is recommended for dermatitis?

Topical corticosteroids Signup and view all the answers

What is a characteristic of drug reactions in dermatitis medicamentosa?

Appear suddenly and vividly colored Signup and view all the answers

Which of the following agents can be effective in treating pruritus in dermatitis?

Antihistamines such as diphenhydramine Signup and view all the answers

What are common triggers for IgE-mediated food allergies?

Seafood and tree nuts Signup and view all the answers

How should patients with a known drug hypersensitivity react to triggers?

Inform others and carry identification regarding their hypersensitivity Signup and view all the answers

What is the leading cause of a food allergy in the adult population?

Genetic predisposition and exposure to allergens Signup and view all the answers

What area of the body is likely to show signs of dermatitis?

Symmetrically on face, neck, and extensor surfaces Signup and view all the answers

Study Notes

Hypersensitivity

Excessive immune response to stimuli, generally not reactive on first exposure due to sensitization.
Type I hypersensitivity (Anaphylaxis) is the most severe, rapid onset reaction, involving edema, hypotension, and bronchospasm.
Cytotoxic (Type II) hypersensitivity involves the immune system misidentifying normal body components as foreign.
Immune Complex (Type III) hypersensitivity involves antigens bonding with antibodies, leading to tissue injury when deposited in tissues.
Delayed-Type (Type IV) hypersensitivity manifests 24 to 72 hours post-exposure and is characterized by T cell-mediated damage.

Diagnostic Evaluation

Eosinophils in a Complete Blood Count may indicate allergic reactions, with percentages over 5% suggesting eosinophilia.
High serum IgE levels can support allergic disease diagnosis.
Skin tests involve applying allergen samples to identify specific sensitivities and reactions.
The Radioallergosorbent Test measures allergen-specific IgE via blood serum testing.

Antihistamines

First-generation antihistamines (e.g., diphenhydramine, hydroxyzine) cause drowsiness and exert anticholinergic effects.
Second-generation antihistamines (e.g., cetirizine, loratadine) have fewer side effects and lower sedation incidence.
Indicated for allergic conjunctivitis, urticaria, nasal symptoms, and adjunctive therapy in anaphylaxis.

Nursing Implementation for Antihistamines

Administer one hour prior or two hours post meals to optimize effects.
Advise use of sugarless candies for dry mouth relief.
Ensure safety measures to prevent falls and injuries.
Encourage increased fluid intake to combat thickened secretions.
Implement skin care strategies to avoid breakdown and complications.
Recommend avoiding alcohol, as it can enhance sedation.

Anaphylaxis

A systemic hypersensitivity reaction with symptoms including hypotension, airway obstruction, and severe hypoxia.
Common triggers: latex, penicillin, local anesthetics; reactions arise within minutes of exposure.
Initial signs include generalized itching, coughing, respiratory difficulty, and potential loss of consciousness.
Management focuses on immediate epinephrine administration to counteract symptoms.

Contact Dermatitis

Caused by direct exposure to allergens or irritants, leading to sensitization characterized by a pruritic rash post-exposure.
Symptoms include erythema, edema, and vesicular lesions.
Effective treatment involves removing irritants and employing topical glucocorticoids.

Atopic Dermatitis

Also known as atopic eczema, is characterized by chronic inflammation and skin hyperreactivity.
Eosinophilia and elevated serum IgE levels confirm the allergenic basis.
Complications include secondary infections and increased sensitivity to irritants.
Common symptoms include dry, scaling skin, lichens, and intense pruritus.

Dermatitis Medicamentosa (Drug Reactions)

Type I hypersensitivity presenting with skin rashes following medication exposure.
Rashes are vivid and resolve quickly upon discontinuation of the triggering medication.
Patients must be informed of their hypersensitivity and carry identification to avoid future exposure.

Food Allergy

Type I IgE-mediated reaction affecting about 2% of adults, often due to genetic predisposition and early exposure.
Common allergens include seafood (e.g., shellfish, fish), legumes (peanuts, beans), seeds, tree nuts, milk, and chocolate.

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Description

This quiz covers the management of patients with various allergic disorders, focusing on hypersensitivity, antihistamines, anaphylaxis, and specific types of dermatitis. Participants will explore the mechanisms and treatments for conditions such as food allergies and drug reactions. Perfect for healthcare professionals seeking to enhance their understanding of allergic conditions.