anaphylactic shock, a severe and sometimes fatal systemic allergic reaction to an allergen, such as a drug, vaccine, specific food, serum, allergen extract, insect venom, or chemical. This condition may occur within seconds to minutes from the time of exposure to the allergen and is commonly marked by respiratory distress and vascular collapse. The quicker the systemic atopic reaction in the individual after exposure, the more severe the associated shock is likely to be. ▪ OBSERVATIONS: The first symptoms are intense anxiety, weakness, and a feeling of impending doom. Sweating and dyspnea may occur. These are followed, often quickly, by pruritus and urticaria. Other symptoms include hypotension, shock, arrhythmia, respiratory congestion, edema of the glottis, nausea, and diarrhea. ▪ INTERVENTIONS: Treatment requires the immediate intramuscular or subcutaneous injection of epinephrine, The airway is maintained, and the patient is carefully monitored for signs of edema of the glottis, which may require the insertion of an endotracheal tube. The signs of edema of the glottis include stridor, hoarseness, and dyspnea. Cardiopulmonary resuscitation is indicated in cardiac arrest. ▪ PATIENT CARE CONSIDERATIONS: Nursing care requires appropriate emergency treatment and close monitoring for respiratory distress, hypotension, and decreased circulatory volume. Patients with a history of severe allergic reactions are instructed to avoid offending allergens; some patients must carry emergency anaphylaxis kits, such as an EpiPen Auto-Injector containing injectable epinephrine.
