An adolescent boy is admitted to the emergency department (ED) following a bee sting. He arrives with a body rash and 30 minutes later he becomes short of breath. The nurse obtains vital signs with a blood pressure of 90/52 mm Hg, heart rate 130 beats/minute, and respiratory rate 40 breaths/minute. The client is exhibiting clinical manifestations of which type of immune reaction?

Choice A reason: Temporary use until pressure stabilizes is incorrect, as open-angle glaucoma is a chronic condition requiring ongoing intraocular pressure control. Eye drops, like beta-blockers, reduce aqueous humor production, but stopping them risks pressure spikes, leading to optic nerve damage and vision loss.

Choice B reason: Lifelong eye drop use is accurate, as open-angle glaucoma is a progressive disease where optic nerve damage is prevented by maintaining low intraocular pressure. Drops like prostaglandins increase aqueous outflow, requiring continuous use to prevent irreversible vision loss, making this the correct response.

Choice C reason: Using drops only during symptomatic episodes is incorrect, as glaucoma is often asymptomatic until advanced. Consistent eye drop use prevents pressure buildup, protecting the optic nerve. Symptomatic treatment fails to address chronic pressure elevation, risking progressive vision loss.

Choice D reason: Discontinuing drops once vision improves is incorrect, as vision improvement is not expected in glaucoma. Eye drops maintain intraocular pressure to slow disease progression, not reverse damage. Stopping treatment allows pressure to rise, accelerating optic nerve damage and vision loss.

Choice A reason: Testing for Helicobacter pylori is irrelevant, as vomiting and anorexia 8 days post-laparotomy suggest postoperative complications like ileus or obstruction, not peptic ulcer disease. H. pylori causes gastritis, not acute surgical issues, making this action inappropriate for the client’s current presentation.

Choice B reason: Giving intravenous fluids is critical, as vomiting and refusal to eat post-laparotomy risk dehydration and electrolyte imbalances. Fluids restore volume, stabilize hemodynamics, and support recovery from potential ileus or obstruction, addressing the client’s acute symptoms and preventing further deterioration.

Choice C reason: Inserting a rectal tube is inappropriate, as vomiting indicates upper gastrointestinal issues, not lower bowel obstruction. Post-laparotomy vomiting suggests ileus or adhesion, and rectal tubes do not address gastric or small bowel complications, making this action ineffective.

Choice D reason: Monitoring hemoglobin assesses blood loss, relevant post-laparotomy, but vomiting and anorexia prioritize fluid replacement to prevent dehydration. Hemoglobin checks are secondary, as fluid loss is the immediate threat, making IV fluids the more urgent intervention for stabilization.