Anaphylactic Case Study
Concept: Immunity
Scenario:
Tera Smith is a 22 year old female who is brought into the Emergency Department by ambulance after sudden changes in her level of consciousness and difficulty speaking when talking to friends at a party. Her friends called 911 when she became increasingly agitated and incoherent.
Vital signs on admit were:
- B/P 80/62,
- Resp: 8 with difficulty,
- Pulse 120,
- temp 39.2,
- O2 sats: 82.
Patient was still conscious on admit but confused and disoriented and unable to speak. Patient was very restless and anxious.
A few of her friends arrived at the emergency room and it was discovered that she had eaten some cookies that were thought to have peanuts in them right before the event occurred. Family could not been contacted to determine if Tera had a previous documented allergy to nuts/peanuts. Her friends were unaware of such an allergy in her history but never remember seeing her eating nuts of any kind in the past.
Questions:
1.With the information provided above what kind of shock is the patient experiencing?
2.What is the number one priority with this patient and what medication do you anticipate being administered? How is this medication going to work to assist the patient?
3.What additional questions would you want to find out about the patient from family andfriends?
4.What labs would possibly be done and why?
5.What will be done to stabilize this patient and how important is time in stabilizing her?
Tera Smith is now stable but is still experiencing trouble breathing and not feeling well, and is admitted on the floor for observation. Her family is her bedside. Tera admits that she has an allergy to peanuts, but didn't think there was enough in the cookies to cause a reaction. She thought a little wouldn't hurt because in the past she has only had small reactions but says she learned her lesson and will be more cautious of what is in the foods she eats.
6.What would you be sure to instruct Tera and her family upon discharge to prevent a repeat of this episode in the future?
Developed by Carol Thorn, RN, MS
May use with permission for the purposes of nursing education
If questions/comments, please contact Carol Thorn at