Chapter 53 Assessment and Management of Patients With Allergic Disorders pp538-541

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Inflammation Unit II Lecture 2 Lee Resurreccion. Chapter 53 Assessment and Management of Patients With Allergic Disorders pp538-541 . Allergic Reactions. Allergy An inappropriate, often harmful response of the immune system to normally harmless substances
Chapter 53 Assessment and Management of Patients With Allergic Disorders pp538-541

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Chapter 53 assessment and management of patients with allergic disorders pp538 541 l.jpgSlide 1

Inflammation Unit II Lecture 2

Lee Resurreccion

Chapter 53 Assessment and Management of Patients With Allergic Disorderspp538-541

Allergic reactions l.jpgSlide 2

Allergic Reactions

  • Allergy

    • An inappropriate, often harmful response of the immune system to normally harmless substances

    • Hypersensitive reaction to an allergen initiated by immunological mechanisms that is usually mediated by IgE antibodies

  • Allergen: the substance that causes the allergic response

  • Atopy: allergic reactions characterized by IgE antibody action and a genetic predisposition

Immunoglobulins and allergic response l.jpgSlide 3

Immunoglobulins and Allergic Response

  • Antibodies (IgE, IgD, IgG, IgM, and IgA) react with specific effector cells and molecules, and function to protect the body

  • IgE antibodies are involved in allergic disorders

  • IgE molecules bind to an allergen and trigger mast cells or basophils

  • These cells then release chemical mediators such as histamine, serotonin, kinins, SRS-A, and neutrophil factor

  • These chemical substances cause the reactions seen in allergic response

Immunoglobulins and allergic response cont l.jpgSlide 4

Immunoglobulins and Allergic Response (cont.)

  • Allergen triggers the B cell to make IgE antibody, which attaches to the mast cell; when that allergen reappears, it binds to the IgE and triggers the mast cell to release its chemicals

Hypersensitivity l.jpgSlide 5


  • A reflection of excessive or aberrant immune response

  • Sensitization: initiates the buildup of antibodies

  • Types of hypersensitivity reactions

    • Anaphylactic: type I

    • Cytotoxic: type II

    • Immune complex: type III

    • Delayed type: type IV

Type i anaphylactic reaction l.jpgSlide 6

Type I—Anaphylactic Reaction

Anaphylaxis l.jpgSlide 7


Management of patients with allergic disorders l.jpgSlide 8

Management of Patients With Allergic Disorders

  • History and manifestations; comprehensive allergy history

  • Diagnostic tests

    • CBC-eosinophil count

    • Total serum IgE

    • Skin tests: note precautions

  • Screening procedures

Anaphylaxis9 l.jpgSlide 9


  • Histamine release

  • Initial symptoms=edema/itching at site

    Systemic reaction occurs within minutes:

  • Shock

    • Bronchial constriction, airway constriction

    • Airway constriction

    • S&S: rapid weak pulse, hypotension, dilated pupils

  • Prevention and treatment of anaphylaxis l.jpgSlide 10

    Prevention and Treatment of Anaphylaxis

    • Screen and prevent

    • Treat respiratory problems; provide oxygen, intubation, and cardiopulmonary resuscitation as needed


    • Epinephrine: 1:1,000SQ

    • Auto injection system: EpiPen

    • May follow with IV epinephrine

    • IV fluids

    Self administration of epinephrine l.jpgSlide 11

    Self-Administration of Epinephrine

    Allergic rhinitis l.jpgSlide 12

    Allergic Rhinitis

    • Also called hay fever and seasonal allergic rhinitis, allergic rhinitis is a common respiratory allergy presumed to be mediated by a type I hypersensitivity

    • Affects 10% to 25% of the population

    • Symptoms include sneezing and nasal congestion; clear, watery discharge; nasal itching; itching of throat and soft palate; dry cough; hoarseness; and headache

    • May affect the quality of life, producing fatigue, loss of sleep, and poor concentration

    Nursing process assessment of the patient with allergic rhinitis l.jpgSlide 13

    Nursing Process—Assessment of the Patient With Allergic Rhinitis

    • Assess health history

    • Include personal and family history

    • Perform an allergy assessment

    • Subjective data includes symptoms and how the patient feels before symptoms become obvious

    • Note the relationship between symptoms and seasonal changes, emotional problems, and stress

    • Identify nature of antigens, seasonal changes in symptoms, and medication history

    Nursing process diagnosis of the patient with allergic rhinitis l.jpgSlide 14

    Nursing Process—Diagnosis of the Patient With Allergic Rhinitis

    • Ineffective breathing pattern related to allergic reaction

    • Deficient knowledge about allergy and the recommended modifications in lifestyle and self-care practices

    • Ineffective individual coping with the chronicity of the condition and the need for environmental modifications

    Collaborative problems potential complications l.jpgSlide 15

    Collaborative Problems/Potential Complications

    • Anaphylaxis

    • Impaired breathing

    • Nonadherence to therapeutic regimen

    Nursing process planning the care of the patient with allergic rhinitis l.jpgSlide 16

    Nursing Process—Planning the Care of the Patient With Allergic Rhinitis

    • Goals may include:

      • Restoration of normal breathing pattern

      • Increased knowledge about the causes and control of allergic symptoms

      • Improved coping with alterations and modifications

      • Absence of complications

    Improved breathing pattern l.jpgSlide 17

    Improved Breathing Pattern

    • Modify the environment to reduce allergens

    • Reduce exposure to people with upper respiratory infection

    • Take deep breaths and cough frequently

    Promoting understanding patient teaching l.jpgSlide 18

    Promoting Understanding/Patient Teaching

    • Instruction to minimize allergens

    • Use of medications

    • Desensitization procedures

    Other allergic disorders l.jpgSlide 19

    Other Allergic Disorders

    • Contact dermatitis

    • Atopic dermatitis

    • Drug reactions

    • Urticaria

    • Food allergy

    • Latex allergy

    Type ii cytotoxic reaction l.jpgSlide 20

    Type II—Cytotoxic Reaction

    Type iii immune complex reaction l.jpgSlide 21

    Type III—Immune Complex Reaction

    Type iv delayed or cellular reaction l.jpgSlide 22

    Type IV—Delayed or Cellular Reaction

    Wound healing l.jpgSlide 23

    Wound Healing

    • First intention

    • Second intention

    • Third intention

    First intention healing l.jpgSlide 24

    First-Intention Healing

    • Wound margins well approximated

      • Surgical incisions

    • Phases:

      • Initial (3-5 days)-fills w/blood, fibrin clots, erythrocytes (RBC’S), neutrophils

      • Granulation (5 days-3 weeks)-proliferation phase

      • Scar contraction and maturation-collagen fibers are further organized

        (7 days after injury increases over several months)

    Second intention healing l.jpgSlide 25

    Second-Intention healing

    • Wide, irregular wound margins

      • Trauma

      • Ulceration

      • Infection

    • Wound classification

      • Red-granulation tissue

      • Yellow-presence of slough/necrotic tissue

      • Black-debridement

    Wound red l.jpgSlide 26


    Wound yellow l.jpgSlide 27


    Wound black l.jpgSlide 28

    Wound -Black

    Third intention healing l.jpgSlide 29

    Third-Intention Healing

    • Delayed primary intention

      • Delayed suturing

      • Infection

    • Larger deeper scar

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