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
C
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A) Both the statement and reason are correct but not related. B) Both the statement and reason are correct and related. C) The statement is not correct, but the reason is correct. D) Neither the statement nor the reason is correct. E) The statement is correct, but the reason is not.
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