Your patient is a? 31-year-old female complaining of dizziness and difficulty breathing after being stung by a bee. You note that she is extremely? anxious, and your physical examination reveals a rapidly developing urticaria to her? shoulders, neck, and face. Your partner has administered oxygen via a? nonrebreather, initiated IV? access, placed the patient on the cardiac? monitor, and administered epinephrine SC and diphenhydramine IV. Despite? this, you also note that her voice is quickly becoming more hoarse and she has developed expiratory wheezes in all lung fields. HR? = 128, BP? = 100/70, RR? = 20, SaO2? = 99%. What should be your major concern at this? point, and what is the most appropriate? treatment?
a. Hypotension leading to cardiovascular collapse; administer fluids wide open and initiate a dopamine infusion
b. Increased bronchospasm leading to respiratory arrest; administer albuterol via nebulizer
c. Laryngeal edema leading to total airway occlusion; intubate
d. Increased bronchospasm leading to respiratory arrest; administer epinephrine IV
Ans: c. Laryngeal edema leading to total airway occlusion; intubate
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