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Multiple Choice
What is the first action a nurse should take when there is any indication of an allergic reaction in a client?
A
Administer antihistamines immediately.
B
Notify the client's family about the allergic reaction.
C
Assess the client's airway, breathing, and circulation.
D
Document the allergic reaction in the client's medical record.
Verified step by step guidance
1
Begin by understanding the importance of the ABCs in emergency situations: Airway, Breathing, and Circulation. These are critical components to assess in any medical emergency, including allergic reactions.
Recognize that an allergic reaction can potentially lead to anaphylaxis, a severe and life-threatening condition that requires immediate attention to the client's airway, breathing, and circulation.
Assess the client's airway to ensure it is clear and unobstructed. Look for signs of swelling or difficulty breathing, which are common indicators of an allergic reaction.
Evaluate the client's breathing by observing their respiratory rate and effort. Listen for wheezing or other abnormal sounds that may suggest respiratory distress.
Check the client's circulation by assessing their pulse and blood pressure. Look for signs of shock, such as a weak pulse or low blood pressure, which can occur during severe allergic reactions.