Chapter 18.

Immediately after giving an epinephrine injection, you should:

properly dispose of the syringe.

While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates:

narrowing of the bronchioles in the lungs.

Common signs and symptoms of an allergic reaction include all of the following, EXCEPT:

drying of the eyes.

The two MOST common signs of anaphylaxis are:

wheezing and widespread urticaria.

After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should:

monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.

Most patients who die of anaphylaxis do so within the first __________ following exposure.

30 minutes

Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include:

histamines and leukotrienes.

The stinger from a honeybee should be:

scraped away from the skin.

Urticaria is the medical term for:

hives.

Which of the following medications blocks the release of histamines?

diphenhydramine (Benadryl)

A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called:

a wheal.

A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?

Administer oxygen, transport at once, and request a paramedic intercept.

Which of the following MOST accurately defines an allergic reaction?

an exaggerated immune system response to any substance

The effects of epinephrine are typically observed within _________ following administration.

1 minute

The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the pediatric auto-injector delivers ______ mg.

0.3, 0.15

Anaphylaxis is MOST accurately defined as a(n):

extreme allergic reaction that may affect multiple body systems.

Which of the following patients would MOST likely have a delayed onset of an allergic reaction?

a 45-year-old male who ingested penicillin

A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. In addition to administering oxygen, you should:

contact medical control if needed, transport the patient, and monitor him for signs of deterioration.

Which of the following would MOST likely provide clues regarding the source of a patient’s allergic reaction?

the environment in which the patient is found

A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should:

maintain his airway and assist his ventilations.

A 38-year-old female was bitten by fire ants while at the park with her kids. Your primary assessment reveals that she is semiconscious, has profoundly labored breathing, and has a rapid, thready pulse. She has a red rash on her entire body and her face is very swollen. You should:

assist her ventilations with 100% oxygen.

The foreign substance responsible for causing an allergic reaction is called a(n):

allergen.

Because the stinger of a honeybee remains in the wound following a sting:

it can continue to inject venom for up to 20 minutes.

A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should

administer oxygen and transport her to the hospital.

You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should:

request permission from medical control to give another dose of epinephrine.

Which of the following physiologic actions does epinephrine produce when given for an allergic reaction?

vasoconstriction and bronchodilation

Common side effects of epinephrine include all of the following, EXCEPT:

drowsiness.

Epinephrine is indicated for patients with an allergic reaction when:

wheezing and hypotension are present