The nurse should expect to assess which finding in a patient with a mild reaction to a snake bite of the index finger?
A) Scratches or small lacerations on the finger accompanied by localized edema of the finger.
B) Scratches or small lacerations on the finger accompanied by edema of the hand.
C) Heavy bleeding from the wound and thrombocytopenia.
D) Significant edema, hypovolemia, and shock.
A) Scratches or small lacerations on the finger accompanied by localized edema of the finger.
Explanation: A) Mild reactions include scratches or small lacerations from the physical fangs. These reactions are not accompanied by any systemic responses beyond the possibility of minor localized edema caused by the puncture or laceration of the skin.
B) Moderate reactions include extension of edema beyond the site of the bite. These reactions are not considered to be life threatening.
C) Severe reactions emerge from anaphylactic responses to snake venom or from physiologic receptor blockade. Select venoms can result in coagulopathy, leading to thrombocytopenia and excessive bleeding. Bleeding into tissue and significant edema lead to a reduction in circulatory volume. The lack of adequate circulating volume then contributes to hypotension and possibly shock. Hypotension in combination with hemolysis can then contribute to the development of acute renal failure.
D) Severe reactions emerge from anaphylactic responses to snake venom or from physiologic receptor blockade. Select venoms can result in coagulopathy, leading to thrombocytopenia and excessive bleeding. Bleeding into tissue and significant edema lead to a reduction in circulatory volume. The lack of adequate circulating volume then contributes to hypotension and possibly shock. Hypotension in combination with hemolysis can then contribute to the development of acute renal failure.
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