RUNNING HEAD: ANAPHYLAXIS

Anaphylaxis

Mary Freyah P. Felimon

Central Mindanao University

College of Nursing

Ellen Gay S. Intong RN, PhD

February 14, 2018

RUNNING HEAD: ANAPHYLAXIS

Anaphylaxis

INTRODUCTION

Anaphylaxis is a serious, life-threatening allergic reaction. The most common

anaphylactic reactions are to foods, insect stings, medications and latex allergies.

If you are allergic to a substance, your immune system overreacts to

this allergen by releasing chemicals that cause allergy symptoms. Typically, these
bothersome symptoms occur in one location of the body. However, some people are
susceptible to a much more serious anaphylactic reaction. This react ion typically
affects more than one part of the body at the same time.

DEFINITION

Anaphylaxis is an acute, potentially fatal, multi-organ system reaction caused by the

release of chemical mediators from mast cells and basophils. It is a clinical response to an
immediate (Type1 Hypersensitivity) immunologic reaction between a specific antigen and
antibody. This reaction results from a rapid release of IgE-mediated chemicals, which can
induce a severe, life-threatening allergic reaction.

SIGNS & SYMPTOMS

Anaphylactic reactions produce a clinical syndrome that affects multiple organ systems.
Reactions may be categorized as mild, moderate, or severe. The time from exposure to the
antigen to onset of symptoms is a good indicator of the severity of the reaction-the faster the
onset, the more severe the reaction. The severity depends on the degree of allergy and the dose
of allergen.

Mild systemic reactions consist of peripheral tingling and a sensation of warmth,

possibly accompanied by a sensation of warmth, possibly accompanied by a sensation of
fullness in the mouth and throat. Nasal congestion, periorbital swelling, pruritus, sneezing and
tearing of the eyes can also be expected. Onset of symptoms begins within the first 2 hours
after exposure.
RUNNING HEAD: ANAPHYLAXIS

Moderate systemic reactions may include flushing, warmth, anxiety and itching in
addition to any of the milder symptoms. More serious reactions include bronchospasm and
edema of the airways or larynx with dyspnea, coughing and wheezing. The onset of symptoms
is the same as for a mild reaction.

Severe systemic reactions have been an abrupt onset with the same signs and symptoms
described previously. These symptoms progress rapidly to bronchospasm, laryngeal edema,
severe dyspnea, cyanosis and hypotension. Dysphagia, abdominal cramping, vomiting,
diarrhea and seizures can also occur. Cardiac arrest and coma may follow.

PATHOPHYSIOLOGY

Anaphylaxis is caused by the interaction of a foreign antigen with specific IgE

antibodies found on the surface membrane of mast cells and peripheral blood basophils. The
subsequent release of histamine and other bioactive mediators causes activation of platelets,
eosinophils and neutrophils. Histamines, prostaglandins and inflammatory leukotrienes are
potent vasoactive mediators that are implicated in the vascular permeability changes, flushing,
urticarial, angioedema, hypotension and bronchoconstriction that characterize anaphylaxis.
Smooth muscle spasm. Bronchospasm, mucosal edema and inflammation, and increased
capillary permeability result. These systemic changes characteristically produce clinical
manifestations within seconds or minutes after antigen exposure.

NURSING INTERVENTION

Independent

 Assess patient’s airway, breathing pattern and vital signs. Rationale: ABC (Airway,
Breathing, and Circulation) is the primary prioritization in this kind of episode; Checks
client for the sensation of a narrowed airway
 Observe patient for signs of increasing edema and respiratory distress. Rationale: May
indicate a worsening allergic reaction.
 Position the client upright. Rationale: this position provides oxygenation by promoting
maximum chest expansion
 Limit activities within client’s tolerance. Rationale: For safety purposes and to avoid
further occurrences of anaphylaxis.
RUNNING HEAD: ANAPHYLAXIS

Dependent

 Initiate rapidly emergency measures (intubation, administration of emergency

medications, insertion of intravenous lines, fluid administration and oxygen
administration. Rationale: To reduce the severity of the reaction and to restore
cardiovascular function.
 Administer intravenous fluids, volume expanders, and vasopressor agents as
prescribed. Rationale: To maintain blood pressure and normal hemodynamic status.
 Administer aminophylline and corticosteroids to patients with episodes of
bronchospasm or history of bronchial asthma or chronic obstructive pulmonary disease.
Rationale: To improve airway patency and function.

Source:

Hinkle, J.L., Cheever, K.H.(2014).Brunner & Suddarth’s textbook of medical-surgical

nursing (Edition 13). Philadelphia: Wolters Kluwer Health/Lippincott Williams &
Wilkins.
RUNNING HEAD: ANAPHYLAXIS