Precipitating Factors:

Exposure to allergen Predisposing Factors:

Medications (penicillin)
Insect Venoms Anaphylactic Shock Family History of anaphylaxis
Latex
Food (nuts, seafood)

Laboratory studies:
Initial Exposure to allergen
Tryptase test
Histamine Test
Immune response Skin test

Innate immunity Formation of IgE attaching Adaptive immunity

to mast cells

Mast cell degranulation

Histamine release Cytokine release

INITIAL STAGE
Tx: Epinephrine Activation of WBCs

Vasodilation Inc. capillary Increase

Inc. Gi secretion Skin reaction
Permeability secretions in the
respiratory tract
Dec. Blood -vomiting Vascular fluid
Pressure -diarrhea -itchiness transfer to
-pain -redness interstitial Airway
space obstruction
Dec. Venous
Altered tissue perfusion
return to the heart
r/t decreased blood flow Impaired skin integrity
r/t changes in -Peripheral -coughing
circulation -chest tightness
Dec. cardiac output Dec. 02 swelling
saturation -dyspnea
TX: Epinephrine
Dec. tissue perfusion Ineffective
airway clearance
r/t accumulation
Cells react to hypoxia Organs compensate loss of blood of secretions
volume

Anaerobic metabolism
used kidneys Liver Lungs

Increase amount of Dec. blood Release Dec. lung

lactic acid pressure angiotensin perfusion

Muscle pain Renin-angiotensin Lung areas

-body cramps system is activated not perfused
COMPENSATORY
-fatigue
STAGE
Dec. gas
Renin is released exchange

V/Q mismatch
Angiotensin 2 Adrenal cortex
activation
-Inc. Respiratory rate
(hyperventilation)
 vasoconstriction Aldosterone
released Impaired gas exchange
r/t ventilation
Na & H20 are perfusion imbalance
Inc. blood pressure and retained
venous blood return

Inc. urine
Inc. CO and tissue osmolality
perfusion

PROGRESSIVE
STAGE Signals posterior
pituitary gland of
Compensatory low blood volume
-hypotension
mechanism fails
-chest pain
-clammy and PPG produces
cool skin anti-diuretic
Complete drop of
-Fainting hormone
cardiac output
-Diminished
-changes in skin peripheral Fluid retention
color pulses
Prolonged 02
-rapid heart rate
deprivation
-rapid breathing
Inc. blood volume
-sweating
Starvation of cells
O2 therapy
IV antihistamines

Cells develop
hypoxic injury Monitor airway
and arterial blood Monitor
gas values and Urine output
Cell death proper
positioning

Liver Brain Lungs kidneys heart GI

Dec. Dec. MAP Inc. capillary hypoxia Hypoxia to cells Inc. gastric
production (<60 mmhg) permeability secretions
of clotting
factors Nephrons Myocardial infarct Dec. protective
Dec.
Fluids enter stop working mechanism of
cerebral
Risk for the alveoli stomach lining
perfusion
infection and pressure Heart failure
Acute tubular
massive Alveoli necrosis Stomach ulcer
blood clotting collapse
O2 formation
(DIC)
deprived -Dysrhythmias
brain Acute renal -Dec.
Dec. Lung contractions GI bleeding
Failure
compliance

-Dec. urinary output Acute pain r/t

Acute respiratory -Inc. BUN, Creatinine gastric
distress syndrome irritation

-mental status
Endotracheal
changes
Respiratory Failure intubation
-slow speech
-agitation
-confusion
-unresponsiveness
 REFRACTORY Multiple organ
STAGE dysfunction syndrome

DEATH

LEGEND:

Anaphylactic Shock

Risk Factors

Signs and Symptoms

Treatment

Complication

Laboratory studies

Nursing Diagnosis

Physiologic sequence

Stages

Organs