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Other Medications: Corticosteroids (hydrocortisone) and aminophylline for swelling and

bronchospasm; inhaled beta-adrenergic agonists such as albuterol, severe hypotension

can be treated with vasopressor agents such as norepinephrine (Levophed).

76 Angina Pectoris Independent

The most important priority for nurses is to ensure adequacy of the airway, breathing, and circulation. Keep intubation equipment available for immediate use. Insert an oral or nasal airway if the patient is at risk for airway occlusion but has adequate breathing. Use an oral airway for unresponsive patients and a nasal airway for patients who are responsive. If endotracheal intubation is necessary, secure the tube firmly and suction the patient as needed to maintain the airway. If the patient has a compromised circulation that does not respond to pharmacologic intervention, begin cardiopulmonary resuscitation with chest compressions.

Teach the patient and family how to prevent future allergic reactions. Explain the nature of the allergy, the signs and symptoms to expect, and measures to perform if the patient is exposed to the allergen. Teach the patient that if shortness of breath, difficulty swallowing, or the formation of the "lump in the throat" occurs, she or he should go to an emergency department immediately. If the allergen is a medication, make sure the patient and family understand that they must avoid the various sources of the medication in both prescription drugs and available over-the-counter preparations for the rest of their lives. Encourage the patient to notify all healthcare providers of the allergy prior to treatment.

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