Post – Alexandra-DQ2

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Respond to at least two of your colleagues who selected at least one different factor than you in one of the following ways:

Share insights on how the factor your colleague selected impacts the pathophysiology of anaphylactic shock.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

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 Anaphylactic shock is a widespread hypersensitivity reaction called anaphylaxis (Huether & McCance, 2017).  Anaphylactic shock causes an accelerated allergic reaction that releases large amounts of histamine, which therefore results in vasodilation (Huether & McCance, 2017).  When a sensitized individual is exposed to an allergen it results in an anaphylactic shock which the physiologic alteration is similar to a neurogenic shock (Huether & McCance, 2017).  The physiologic alteration would include vasodilation and relative hypovolemia which then leads to a decreased tissue perfusion and impaired cellular metabolism (Huether & McCance, 2017).  The entire body is affected rapidly when it goes into an anaphylactic shock.

            According to Pistener & Mattey (2017), Anaphylaxis is a life-threatening emergency and in the school setting, school nurses prepare plans to prevent an emergency, educating staff and students on life-threatening allergies. An anaphylactic shock is defined as a sudden onset of one or more allergic reaction symptom lasting less than twenty-four hours; such as wheezing, rash, hives, itching, shortness of breath, angioedema, stridor, nausea, vomiting, dizziness, anxiety or diarrhea (Jacobsen & Gratton, 2011).  If I was the nurse practitioner in the school and the child came in complaining of one or more of the anaphylactic shock’s symptoms, I would first check my anaphylactic shock emergency plan and see if the child is carrying his Epinephrine pen or if the school has it. If the child has the Epinephrine pen or the school has it, I would administer the medication rapidly in order to avoid death. If the child and the school does not have the epinephrine pen, I would call 911 and report my findings and refer the patient to emergency care.  If the child came in complaining of a rash or hives that he/or she has had for a couple days, I would treat them in an outpatient setting and call their parents.

            Genetics is one of the factors I selected for anaphylactic shock due to genetically predisposed individuals, allergens such as shellfish, peanuts, latex, medications, and insect venoms initiate a humoral immune response (type I hypersensitivity reaction) that result in a mass production of immunoglobulin E (IgE) antibodies (Huether & McCance, 2017). The mast cells are de-granulated due to the allergen binding to IgE; thus, a mast cells release vasoactive and inflammatory cytokines in large quantities (Huether & McCance, 2017). The end product is the immune and inflammatory response is triggered causing vasodilation, increased vascular permeability, peripheral pooling, tissue edema, and constriction of extravascular smooth muscle which causes laryngospasm and bronchospasm as well as abdominal cramping (Huether & McCance, 2017).  Lastly, the immune system of a person with an allergy will perceive the allergen as a dangerous body. This would then create an antibody to fight off the foreign body.  This is when the process of an allergic reaction begins (Jacob, 2018).

Behavior is the second factor that impacts anaphylactic shock.  There are times when the patient is not aware of an exposure to allergen. The patient would then have an anaphylactic shock very rapidly which can result into a life-threatening situation. Patients with allergens causing anaphylaxis needs to be educated in carrying an epinephrine pen at all times.  Eating out in restaurants where they cook foods in close proximity, the patients needs to be educated in alarming the waiter that they have a food allergen.

References

Huether, S. E., & McCance, K.L. (2017). Understanding pathophysiology (6th ed.). St. Louis, 

MO: Mosby.

Jacob, L. M. (2018). Anaphylaxis. Salem Press Encyclopedia of Health. Retrieved from https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=ers&AN=87325288&site=eds-live&scope=site

Jacobsen, R. C., & Gratton, M. C. (2011). A case of unrecognized prehospital anaphylactic 

shock. Prehospital Emergency Care, 15(1), 61-66. Retrieved from http://m.paems.org/pdfs/online-ce/A-case-of-unrecognized-prehospital-anaphylactic-shock.pdf

Pistiner, M., & Mattey, B. (2017). A Universal Anaphylaxis Emergency Care Plan: Introducing the New Allergy and Anaphylaxis Care Plan From the American Academy of Pediatrics. NASN School Nurse (Print), 32(5), 283–286. https://doi-org.ezp.waldenulibrary.org/10.1177/1942602X17713759