- to alleviate her anxiety?

a. Dexter will recover more quickly from infections.

b. Dexter will be protected against secondary infections.
c. Dexter’s level of helpful immunoglobulins will be increased.
d. The overall health of Dexter’s immune system will be increased.
- Ans. C. The nurse should teach that hypo sensitization increases the number of IgG
immunoglobulins, which then block the action of IgE immunoglobulins that are involved
in an allergic response. Immunotherapy does not improve the broader function of the
immune system or protect against infection.

• TEAMWORK AND COLLABORATION - relates to interdisciplinary collaboration

and shared decision making among the healthcare team.
- Question: Any child can have an anaphylactic reaction to a food, drug, or insect sting,
and Dexter is at risk because of his allergy history. If Dexter, who weighs 48 kg, had an
anaphylactic reaction after a bee sting, what is the correct dose of epinephrine for a
school nurse or staff member to give him?
a. 0.03 mg
b. 0.15 mg
c. 0.3 mg
d. 3.0 mg
- Ans. C. Epinephrine is the drug of choice for an anaphylactic reaction because it quickly
causes bronchodilation, immediately enlarging a constricted airway. Emergency
measures for anaphylactic shock indicates the nurse to administer aqueous epinephrine
(Adrenalin) 1:1,000 intramuscularly at a dosage of 0.01 mg/kg of body weight up to 0.3
mg.

• EVIDENCE-BASED PRACTICE (EBP) - relates to the utilization of current evidence

when providing collaborative care. 
- Question: Food allergies are an important concern for nurses working in childcare or
preschool settings because such sites may be where a child eats allergenic food and
experiences a possibly fatal reaction. Early, appropriate administration of epinephrine for
the treatment of the symptoms of anaphylaxis can significantly reduce the likelihood of
anaphylaxis-related hospital admission. Delayed administration of epinephrine
contributes to anaphylaxis-related fatalities.
- Epinephrine is significantly less likely to be injected in food-induced anaphylaxis than in
venom-induced anaphylaxis. Reasons for failure to administer epinephrine include poor
perception of the severity of symptoms or patient refusal (Simons et al., 2015).
- Based on the previous study and the fact that Dexter is allergic to peanuts, which
statement by Dexter’s mother should cause a nurse the most concern?
a. “I pack his lunch every day so I’ll know what he eats.”
b. “He doesn’t need one of those EpiPen things. They are too expensive, and it’s not
like he has a bee sting allergy. If he goes to a party, I’ll ask if peanuts will be
served.”
c. “I know how to read food labels to limit Dexter’s food to things I know are safe.”
- Ans B. The nurse knows that many accidental ingestions occur because food was offered
by another person. A willingness to share may include sharing food and a consequent
allergic reaction that would best be treated by an EpiPen.