B.N., a 41-year-old woman who is a

B.N., a 41-year-old woman who is a dental hygienist, has had several surgeries over the past 5 years because of a knee injury. She presents to the outpatient surgery department today for her last reconstructive surgery. Her past medical history indicates she had asthma as a child and had one occurrence of contact dermatitis. She tells you she has no known drug allergies. You start B.N.’s IV and perform a saline flush. Within three minutes, B.N. states that her IV site itches, and a few minutes later, she begins to complain of itching around her neck and tightness in her throat. Subjective Data States IV site itches States throat and neck feel tight and says, “I feel like I can’t breathe” Objective Data Vital signs: temp 98.8°F, heart rate 120, respiratory rate 32, blood pressure 100/60 Oxygen saturation 85% Wheezing in all lung fields Restless Swelling at IV site 1 What type of altered immune response is B.N. experiencing? 2 What is the apparent causative factor and what were potential sources of exposure? The causative factor appears to be exposure to latex. The exposure may have been in the tourniquet used to start the IV, the gloves the nurse was wearing to start the IV, the adhesive used to secure the IV, the rubber plunger in the disposable syringe, or, if the saline flush was drawn up from a vial, from the rubber top of the vial. 3 What are the priority nursing interventions in this situation? What medications might you expect the health care provider to prescribe? 4 What were B.N.’s risk factors for this type of reaction? 5 Based on this reaction, to what foods should B.N. be tested for allergies? 6 How can such reactions be prevented from occurring? PreviousNext SCIENCE HEALTH SCIENCE NURSING NUR 215

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