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QUESTION
Discuss what symptoms are associated with anaphylactic shock and how the nurse differentiates these from other conditions or issues. What steps should be taken if the nurse suspects anaphylactic shock?
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Answer
Anaphylactic Shock
Anaphylactic shock is an allergic reaction that can be deadly if not treated immediately. Symptoms include difficulty breathing, dizziness, body weakness, loss of consciousness, and confusion (Krčmová, & Novosad, 2019). People experiencing anaphylactic shock will also have symptoms related to low blood pressure and inadequate oxygen flow to body organs; thus, they may lose bowel or bladder function. Anaphylactic reactions are similar to other types of medical attacks, such as asthma attacks or food poisoning.
A nurse can differentiate anaphylactic shock from other allergic reactions as this type of shock typically involves more than one body system (Kann, Long, & Koyfman, 2017). Nursing diagnosis appropriate for patient care involves them evaluating impaired gas exchange related to ventilation-perfusion imbalance. The nurse should also observe alteration of tissue perfusion caused by decreased blood flow due to anaphylactic disorder. Ineffective breathing patterns related to swelling of the nasal mucosa wall, acute gastric irritation, and impaired skin integrity caused by circulation changes should be taken into account to diagnose anaphylactic and differentiate it from other conditions.
If the nurse suspects anaphylactic shock, the nurse should monitor the patient's airways and monitor oxygen saturation and arterial blood gas values while instructing them to breathe slowly and deeply. The nurse should position the client upright to provide oxygenation by promoting maximum chest expansion. The nurse should also monitor the patient's central nervous pressure, pulmonary artery diastolic pressure, cardiac output, and pulmonary capillary wedge pressure. Nurses should check the patient's urine output for signals of inadequate renal perfusion. The nurse should give an intramuscular injection of adrenaline into the outer mid-thigh to reduce the allergic reaction severity.
References
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Kann, K., Long, B., & Koyfman, A. (2017). Clinical Mimics: An Emergency Medicine–Focused Review of Asthma Mimics. The Journal of emergency medicine, 53(2), 195-201.
Krčmová, I., & Novosad, J. (2019). Anaphylactic symptoms and anaphylactic shock. Vnitrni lekarstvi, 65(2), 149-156.
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