A patient experiencing anaphylaxis is in respiratory distress. What is the priority nursing action?

• A. Administer epinephrine and maintain airway; call for help; prepare for advanced airway if needed
• B. Administer antihistamines
• C. Elevate legs
• D. Observe and wait

Answer: (A)

In anaphylaxis with respiratory distress, the top priority is to reverse the reaction and secure the airway. Epinephrine acts fastest to save a life here because it counteracts several life-threatening changes at once: it tightens blood vessels to reduce airway swelling, relaxes bronchial smooth muscle to relieve bronchospasm, and improves cardiac output and perfusion. Administering epinephrine promptly, while immediately maintaining the airway and calling for help, sets the stage for possible advanced airway support if needed.

After giving epinephrine, continue to support breathing with oxygen and monitor closely, establish IV access, and be ready to initiate fluids if there’s hypotension. Supplemental actions like antihistamines or waiting for symptoms to improve won’t address the immediate threat to breathing and airway; elevating the legs doesn’t treat the airway issue and delaying treatment can worsen outcomes.