The nurse knows the following are symptoms of anaphylaxis and they need to intervene quickly.
(Select All that Apply.)

Hypotension

Bradycardia

Hypertension

Tachycardia

Wheezing

Answer and Explanation

Correct Answer : A,D,E

A.   Hypotension: A rapid drop in blood pressure is a hallmark symptom of anaphylaxis.
B.   Bradycardia: Bradycardia is not a common finding in anaphylaxis. Tachycardia (rapid heart rate) is more typical due to compensatory mechanisms.
C.   Hypertension: Anaphylaxis usually causes hypotension due to vascular leakage and vasodilation.
D.   Tachycardia: Tachycardia is commonly seen in anaphylaxis as the heart attempts to compensate for the drop in blood pressure.
E.   Wheezing: Wheezing is a sign of bronchospasm and respiratory distress, which is a common feature of anaphylaxis.

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Correct Answer is C

Explanation

A. Call the physician: This can be done after immediate life-saving interventions are performed.
B. Continue the antibiotic: Continuing the infusion will worsen the reaction.
C. Turn off the antibiotic: Stopping the source of the allergen is the immediate priority to halt the progression of the reaction.
D. Call for help: While assistance is important, turning off the infusion takes precedence.

A. Urticaria B. Pulse rate 104/min C. Wheezing D. BP 98/62

Correct Answer is C

Explanation

A. Urticaria: While hives indicate an allergic reaction, they are less immediately life-threatening than respiratory symptoms.
B. Pulse rate 104/min: Mild tachycardia may be a sign of a systemic response but is not the priority concern.
C. Wheezing: Wheezing indicates airway compromise, a hallmark of anaphylaxis, and requires immediate intervention.
D. BP 98/62: This blood pressure is on the lower side but not critical without other symptoms.

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The nurse knows the following are symptoms of anaphylaxis and they need to intervene quickly. (Select All that Apply.)

Nursing Test Bank

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Explanation

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The nurse knows the following are symptoms of anaphylaxis and they need to intervene quickly.
(Select All that Apply.)