online solution: Samuel Smith is a 50-year-old male patient who presents in t

Samuel Smith is a 50-year-old male patient who presents in the emergencydepartment with a temperature of 101°F (38.3°C), a productive cough, fatigue, and difficulty breathing. He has a history of seasonal allergic rhinitis and mild asthma but no other significant health history. He does not report any known medication allergies.  Mr. Smith’s chest x-ray reveals pneumonia. He is placed on IV penicillin. The nurse returns to check on the patient and finds he is short of breath and extremely anxious about his symptoms and states that his skin is “itching” and he feels dizzy. Upon initial assessment, his pulse is rapid, his lips are blue tinged, a rash is apparent on his chest and arms, and wheezing is heard on auscultation of his lungs. The patient expresses a sense of impending doom. Vital signs at this time are:• Blood pressure – 85/50 mmHg• Heart rate – 130 bpm• Pulse oximetry – 89% The nurse immediately discontinues the IV penicillin. The IV tubing is changed, and normal saline is initiated. Oxygen therapy is provided via a 100% high-flow non-rebreather face mask. Oxygen saturation is monitored via pulse oximetry, and ABGs are ordered. Arterial blood gases indicate respiratory acidosis due to hypoventilation and retained carbon dioxide as bronchial constriction increases with progressive anaphylaxis. On auscultation, audible wheezing with decreased breath sounds in the lower lobes is noted. Mr. Smith complains of severe dyspnea and shortness of breath. Hoarseness is evident. Itchy skin wheals or hives have spread over his body, forming large, red blotches. Angioedema of his lips and mouth is visible. Mr. Smith is placed on a cardiac monitor, which reveals a heart rate of 130 bpm with occasional premature ventricular contractions (PVCs). His BP is 85/50 mm Hg. His oxygen saturation improves to 90% after the initiation of oxygen. Epinephrine 0.5 mg and diphenhydramine 50 mg are administered via IV push. Albuterol is administered via nebulizer to relieve the bronchospasm. Emergency equipment for endotracheal intubation and possible tracheotomy is readied. Mr. Smith’s condition begins to improve. His shortness of breath lessens, and pulse oximetry indicates improved oxygenation at 95%. Vital signs reveal:Blood pressure – 110/60Heart rate – 90  1. What has happened to Mr. Smith?2. Explain pathophysiology of what has occurred, and the actions of the medications given (epinephrine, diphenhydramine and albuterol).  Health Science Science NursingNURSING 202

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