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anaphia 90 anasarca -anaphia /əna¯fe¯⋅ə/, an inability to perceive tactile stimuli. a previously encountered antigen. It is mediated by antibod 5 anaphoresis, (in electrophoresis) the movement of anions ies of the E or G class of immunoglobulins and results in the in a solution or suspension toward the anode. release of chemical mediators from mast cells. The reaction anaphylactic /anЈəfilaktik/ [Gk, ana, up, phylaxis, protec- may consist of a localized wheal and flare of generalized tion], pertaining to anaphylaxis. itching, hyperemia, angioedema, and in severe cases vascu- 5r anaphylactic hypersensitivity, an immediate, systemic lar collapse, bronchospasm, and shock. The severity of hypersensitivity response to an exogenous antigen medi- symptoms depends on the original sensitizing dose of the cated by immunoglobulin E or G. It can be triggered by antigen, the number and distribution of antibodies, and the many substances, including drugs, especially penicillin and route of entry and dose of subsequently encountered anti- other antibiotics; foreign proteins used as therapeutic agents, gen. Penicillin injection is the most common cause of ana- such as insulin, vaccines, allergen extracts, and muscle re- phylactic shock. Insect stings, radiopaque contrast media laxants; insect venom, especially from bees, wasps, hornets, containing iodide, aspirin, antitoxins prepared with animal and fire ants; and certain foods such as shellfish, berries, serum, and allergens used in testing and desensitizing pa- chocolate, eggs, and nuts. Also called type I hypersensitiv- tients who are hypersensitive also produce anaphylaxis in ity. Compare cell-mediated immune response, cytotoxic some individuals. Kinds of anaphylaxis are aggregate ana- anaphylaxis, immune complex hypersensitivity. See also phylaxis, antiserum anaphylaxis, cutaneous anaphylaxis, anaphylactic shock, immunoglobulin. cytotoxic anaphylaxis, indirect anaphylaxis, and inverse 5r anaphylactic reactions [Gk, ana, phylaxis, protection; L, anaphylaxis. —anaphylactic, adj. re, agere, to act], acute allergic responses involving IgE- anaphylaxis management, a nursing intervention from 2112 17 TN new defs mediated antigen-stimulated mast cell activation resulting in the Nursing Interventions Classification (NIC) defined as histamine release. Exposure to the antigen may result in dys- promotion of adequate ventilation and tissue perfusion for a pnea, airway obstruction, shock, urticaria, and, in some patient with a severe allergic (antigen-antibody) reaction. cases, death. Anaphylactic reactions may be caused by Hy- See also Nursing Interventions Classification. menoptera (bee) stings, foods, allergen extract; medications, anaplasia /anЈəpla¯zhə/[Gk,ana ϩ plassein, to shape], a 2113 20 5r or exercise. Rapid administration of subcutaneous epineph- change in the structure and orientation of cells, character- rine is the treatment of choice for severe reactions. ized by a loss of differentiation and reversion to a more 35r anaphylactic shock, a severe and sometimes fatal sys- primitive form. Anaplasia is characteristic of malignancy. .temic allergic reaction to a sensitizing substance, such as a Compare aplasia. —anaplastic /anЈəplastik/, adj drug, vaccine, specific food, serum, allergen extract, insect venom, or chemical. This condition may occur within sec- onds to minutes from the time of exposure to the sensitizing factor (allergen) and is commonly marked by respiratory distress and vascular collapse. The quicker the systemic atopic reaction occurs in the individual after exposure, the more severe the associated shock is likely to be. ■ OBSERVATIONS: The first symptoms are intense anxiety, weakness, and a feeling of impending doom. Sweating and shortness of breath may occur. These are often followed, of- ten quickly, by pruritus and urticaria. Other symptoms in- clude hypotension, shock, arrhythmia, respiratory conges- tion, laryngeal edema, nausea, and diarrhea. ■ INTERVENTIONS: Treatment requires the immediate injection of intramuscular or subcutaneous epinephrine with vigorous massage of the injection site to ensure faster distribution of the drug. The airway is maintained, and the patient is care- Anaplasia (Besser and Thorner, 1994) fully monitored for signs of laryngeal edema, which may re- quire the insertion of an endotracheal tube or a cricothy- rotomy and oxygen therapy. The signs of laryngeal edema include stridor, hoarseness, and dyspnea. Cardiopulmonary anaplastic [Gk, ana, backward, plassein, to mold], per- 2114 20 5r resuscitation may be required for cardiac arrest. taining to anaplasia. ■ NURSING CONSIDERATIONS: Nursing care of patients experi- anaplastic astrocytoma. See glioblastoma multiforme. 2115 20 encing anaphylactic shock requires appropriate emergency anapnea /anapne¯⋅ə/[Gk,ana, pnoia, breath], respiration 2116 25 5 treatment and the close monitoring of the patient for respira- or restoration of breathing after a period of halted respira- tory distress, hypotension and decreased circulatory volume. tion. Patients with a history of severe allergic reactions are in- anapophysis /anЈə⋅pofЈi⋅sis/ [Gk, an-, not, without ϩ 2117 35,01 TN new defs structed to avoid offending allergens; some patients must apophysis, a growing away], an accessory vertebral pro- carry emergency anaphylaxis kits. Such kits contain inject- cess, especially one on a thoracic or lumbar vertebra. able epinephrine, such as an Epi-Pen Auto-Injector. Anaprox, trademark for a nonsteroidal antiinflammatory 2118 07 5r anaphylactoid purpura. See Henoch-Scho¨nlein pur- drug (naproxen sodium). pura. anarthria /ana¨rthre¯⋅ə/ [Gk, a, arthron, not joint], a loss of 2119 39 5r 5r anaphylatoxin /anЈəfı¯Јlətoksin/, a polypeptide derived control of the muscles of speech, resulting in the inability to from complement. Along with other mechanisms, it medi- articulate words. The condition is usually caused by damage ates changes in mast cells leading to the release of histamine to a central or peripheral motor nerve. and other immunoreactive or inflammatory reactive sub- anasarca /anЈəsa¨rkə/ [Gk, ana ϩ sarx, flesh], severe gen- 2120 29 5r stances. eralized, massive edema. Anasarca often occurs in severe -5r anaphylaxis /anЈəfilaksis/ [Gk, ana ϩ phylaxis, protection], cardiovascular renal disease. See also edema. —anasar an exaggerated, life-threatening hypersensitivity reaction to cous, adj.