Final answer:
Clients A, D, and E are at increased risk for anaphylactic shock; A due to a potential reaction to a blood transfusion, D due to a potential reaction to vancomycin, and E due to a known severe allergy to peanuts.
Step-by-step explanation:
The clients at increased risk for anaphylactic shock are the ones who have a previous history of allergies or who are being exposed to potential allergens. Considering the scenarios presented:
- A. The client who is in the first 15 minutes of receiving 1 unit of PRBCs (packed red blood cells) could be at risk because blood transfusions can sometimes trigger an allergic reaction.
- B. The 55 year-old client with spina bifida is not necessarily at increased risk unless there is a known allergy.
- C. The client who is scheduled for a repeat CT scan of the abdomen could be at risk if they have a history of allergic reactions to contrast dye used in the procedure.
- D. The client with an infection who is prescribed intravenous vancomycin may be at risk as vancomycin can sometimes trigger an allergic reaction, particularly the 'red man syndrome' or more severe anaphylaxis.
- E. The client who reports an allergy to peanuts that causes throat swelling is definitely at risk because they have a history of a severe allergic reaction, which is indicative of potential for anaphylactic shock.
Epinephrine is the standard treatment for anaphylaxis, and individuals with known severe allergies are advised to carry an epinephrine auto-injector. Anaphylactic shock requires immediate medical attention.