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What is the priority action for a nurse when a patient shows signs of an allergic reaction?
Asked on May 28, 2026
Answer
When a patient shows signs of an allergic reaction, the nurse's priority is to ensure the patient's airway is open and to assess for any signs of respiratory distress or anaphylaxis. Immediate intervention is crucial to prevent progression to a more severe reaction.
Example Nursing Steps:
- Step 1 – Assess the patient's airway, breathing, and circulation (ABCs) to identify any immediate threats to life.
- Step 2 – Administer emergency medications such as epinephrine if anaphylaxis is suspected, per protocol.
- Step 3 – Monitor vital signs, provide supplemental oxygen if needed, and document the patient's response and interventions.
Additional Comment:
- Always prioritize airway management and be prepared to initiate CPR if necessary.
- Recognize signs of anaphylaxis: difficulty breathing, swelling, rash, and hypotension.
- Ensure emergency equipment and medications are readily available.
- Communicate with the healthcare team promptly to escalate care if needed.
- Document the time and dose of any medication administered during the reaction.
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