After starting an IV dose of sulfamethoxazole (Bactrim), the nurse notes that the patient is having difficulty breathing, his face is flushed, and he complains of abdominal pain. Which type of hypersensitivity reaction is this patient most likely experiencing?


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- Anaphylactic

- Cytotoxic

- Serum sickness

- Infectious


"Anaphylactic" is correct. It is not uncommon for patients to have adverse reactions from medications. Some types of adverse reactions include a cytotoxic response, infectious response and anaphylaxis. An anaphylactic reaction is manifested as difficulty breathing and wheezing, hypotension, abdominal cramping and flushing of the skin, which represent a hypersensitivity of the patients body to the medication.

"Cytotoxic" is incorrect because this type of reaction driven by antibodies that attach themselves to certain cells, leading to various conditions such as myasthenia gravis and hemolytic anemia. The reaction is not immediate like it is with an anaphylactic reaction.

"Serum sickness" is incorrect because with this type of reaction the patient will have fever, itching, joint pain and swollen lymph nodes but will not present with shortness of breath and wheezing.

"Infectious" is incorrect because with infection, the patient will typically present with fever and increased white blood cell count. The effect is not immediate like it is with anaphylaxis, and the symptoms are different.

Silvestri, L. A. (2017). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier

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