The nurse is teaching a school-aged child and parent how to use an epinephrine auto-injector after a documented peanut anaphylaxis. Which statements indicate the teaching has been effective? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Statements 1, 3, 4, and 5 are correct. If symptoms do not improve 5 to 15 minutes after the first dose, a second auto-injector may be administered. Inject into the outer mid-thigh through clothing if necessary and follow the device-specific hold time. Keep two auto-injectors together and readily available, and check expiration dates regularly. After epinephrine, activate emergency medical services even if symptoms improve because symptoms can recur. Statement 2 is incorrect: epinephrine is first-line for anaphylaxis and should not be delayed while waiting for an antihistamine or for breathing to worsen.
Epinephrine is the only first-line treatment for anaphylaxis — every other step (antihistamine, steroid, fluids) is supportive. Delay is the leading cause of fatal anaphylaxis. The triggers for use are airway swelling, respiratory distress, hypotension or shock, OR two or more body systems involved (skin + GI, etc.) — not "stopped breathing."
School-aged child with documented peanut anaphylaxis. The nurse is providing discharge teaching on epinephrine auto-injector use and the post-event action plan. The child and parent return-demonstrate using a trainer device.
Epinephrine auto-injector — Single-dose intramuscular device (0.15 mg pediatric or 0.3 mg adult) for self-administration in anaphylaxis.
Anaphylaxis — IgE-mediated severe systemic allergic reaction with airway, breathing, or circulation involvement; potentially fatal within minutes.
Biphasic reaction — Recurrent anaphylaxis 1 to 72 hours after the initial event without re-exposure; reason for ED observation after epinephrine use.