Anaphylactic Shock
Definition
Anaphylactic is a collection of symptoms that result from an acute
reaction to a foreign substance to a person who previously had the
sensitization (immediate / hypersensitivity reactions indirect
immunity).
Etiology
- Because drugs indirect histamine reaction that usually follows the injection of the drug weight, serum, the x-ray contrast media.
- Certain foods, insect bites.
- The reaction can sometimes idiopathic / immunologic abnormalities manifestations.
- Cardiovascular: tachycardia, hypotension, shock, arrhythmia, palpitations.
- Respiratory tract: rhinitis, sneezing, itching of the nose, bronchospasm, hoarseness, shortness, apnea.
- Gastrointestinal: nausea, vomiting, abdominal pain.
- Skin: pruritus, urticaria, angioedema, skin pale and cold.
Nursing Diagnosis for Anaphylactic Shock
1. Impaired gas exchange related to ventilation perfusion imbalance.
characterized by: shortness of breath, tachycardia, flushing, hypotension, shock, and bronchospasm.
2. Altered tissue perfusion related to decreased blood flow secondary to vascular disorders due to anaphylactic reactions.
characterized by: palpitations, skin pale, cold acral, hypotension,
angioedema, arrhythmias, ECG features horizontal and inverted T waves.
3. Ineffective breathing pattern related to the swelling of the nasal mucosa wall
characterized by: shortness of breath, breath with the lips, there rhinitis.
4. Acute pain related to gastric irritation
characterized by: abdominal pain, looked grimacing while holding stomach.
5. Impaired skin integrity related to changes in circulation
characterized by: swelling and itching of the skin and the nose, there are hives, urticaria, and runny nose.
Source : https://purba-java-indo.blogspot.com/2014/11/5-nursing-diagnosis-for-anaphylactic.html
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