AANP Family Nurse Practitioner (FNP) Certification ExamEvaluationEasy
A 35-year-old female with a history of anaphylaxis to peanuts is prescribed a new medication for her asthma. After the first dose, she develops generalized urticaria, angioedema, and wheezing. Her blood pressure is 80/40 mmHg. Which of the following is the most immediate and critical intervention?
- AAdminister epinephrine 0.3 mg intramuscularly.
- BAdminister intravenous fluids 1 liter bolus.
- CAdminister albuterol nebulizer treatment.
- DAdminister diphenhydramine 25 mg intramuscularly.
Show answer & explanationAnswer & explanation
Correct answer: A. Administer epinephrine 0.3 mg intramuscularly.
The patient is experiencing anaphylaxis, characterized by generalized urticaria, angioedema, wheezing, and hypotension. Epinephrine is the first-line and most critical treatment for anaphylaxis, as it rapidly reverses bronchospasm, vasodilation, and angioedema.
Why the other options are wrong
- B. Intravenous fluids are important for managing hypotension in anaphylaxis but are secondary to epinephrine, which addresses the underlying vasodilation.
- C. Albuterol can help with bronchospasm but does not address the other systemic manifestations of anaphylaxis, especially hypotension and angioedema.
- D. Diphenhydramine can help with urticaria but does not address the life-threatening components of anaphylaxis like bronchospasm and hypotension.
Anaphylaxis Recognition & Treatment
Anaphylaxis is a severe, life-threatening systemic hypersensitivity reaction characterized by rapid onset of skin, respiratory, gastrointestinal, and/or cardiovascular symptoms. Immediate intramuscular epinephrine is the first-line treatment.
- Rapid onset, involves multiple body systems.
- Key symptoms: urticaria, angioedema, wheezing, hypotension, GI distress.
- Epinephrine is the only medication that reverses the progression of anaphylaxis.
Memory trick: When 'A' is for 'Anaphylaxis', 'E' is for 'Epinephrine' first!