What conditions have your ruled out in your differential field diagnosis? Why?

1.During the secondary assessment, inspection of the mouth reveals the mucous membranes to be slightly swollen; breath sounds are present with slight expiratory wheezing. The abdomen is unremarkable, pelvis is stable, and there are no deformities or evidence of trauma to the extremities. The extremities are warm, flushed, and diaphoretic. The peripheral pulses are palpable. The patient states that he is allergic to certain bee stings, for which he carries an EpiPen. “In fact,” he states, “I shot myself with my EpiPen right after I got stung!” His medical history also includes mild asthma, for which he takes albuterol as needed. His last oral intake was 3 hours ago and consisted of a fast-food hamburger and fries. The blood pressure is 128/62 mmHg, heart rate is 118 beats per minute, and respirations are 26 per minute.

a. What conditions have your ruled out in your differential field diagnosis? Why?

b. Based on your differential diagnosis, what are the next steps in emergency care? Why?

c. Based on the history, what type of reaction is this patient experiencing?

d. For the pathophysiologic changes listed here, name the drug and its corresponding dose that would best correct the underlying disturbance: a. SpO 2 84% b. Bilateral wheezing

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