A child comes in to see the school nurse for a possible anaphylactic reaction to peanuts. Which drug should the nurse initially plan to administer to this child, if indicated?
1. Epinephrine through an EpiPen
2. Prednisone, immediately
3. Oxygen
4. Diphenhydramine (Benadryl)
1
Rationale:
1. An EpiPen should be onsite and accessible at all times to the child with an allergy, because anaphylaxis causes bronchoconstriction, and epinephrine initiates dilation of the airways. After administering the medication, 911 should be called.
2. Administration of prednisone is not the priority intervention. It can be administered to prevent reoccurrence of the reaction.
3. Oxygen administration should be done, if needed, after the epinephrine dose is given.
4. Administration of oral diphenhydramine (Benadryl) is not the priority intervention. Benadryl can slow down or stop the production of histamine, which is causing the allergic response, but it does not treat the respiratory compromise and vasodilation caused by the histamine release as a result of the allergic reaction.
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