This Product May Contain Trace Amounts of Peanuts Educating Families & Patients About Food Allergies Kenya Beard EdD GNP-C NP-C ACNP-BC K Beard & Associates, LLC Assistant Professor Hunter College kenya@kbeardandassociates.com regarding food allergies is true? 1. Children can outgrow allergies to food 2. Adults almost always outgrow food allergies 3. The number one food allergy is eggs 4. Almost everyone has a food allergy 1 2 Which of the following is not considered a common food allergy? 1. Almonds 2. Soy 3. Peanuts 4. Mustard The nurse is caring for a client who presents with an anaphylactic reaction. Which of the following signs is most likely to be observed? 1. Extreme elevation in blood pressure 2. Extreme eyelid edema 3. Extreme elevation in immunoglobulin G 4. Extreme facial pallor 3 4 best describes an allergen? 1. A foreign substance that causes an allergic response 2. A foreign substance that results in an anaphylactic response 3. A foreign substance that blocks sensitization 4. A foreign substance that results in the overproduction of red blood cells When a client has an anaphylactic reaction you should know that the quicker the symptoms begin, the 1. quicker the reactions will subside 2. worse the reactions will likely be 3. longer the duration of reactions 4. more milder the reactions will be 5 6 1
regarding epinephrine pens is true? Food Allergies or Food Intolerance 1. Instruct clients to inject epinephrine pens into the deltoid or vastus lateralis muscle 2. Epinephrine should be discarded if it turns from brown to slight yellow 3. Epinephrine works by opposing vasodilation 4. Instruct clients that they should lie down and rest after using an epinephrine pen Food Allergy Contact with food results in symptoms triggered by an immunological response Much greater risk to ones health! Food Intolerance Symptoms triggered by a response outside of an immune response (lactose intolerance) 7 8 Allergic Reactions How Prevalent are They 2% of adults 4-8% of children Results in approximately 30,000 emergency department visits every year Results in the death of over 150 individuals each year (FDA, 2010) Cow s milk Eggs Fish Peanuts Shellfish Soy Tree nuts Wheat Top Food Allergies American Academy of Allergy Asthma & Immunology, 2011 9 10 Common Food Allergies Adults Fish (including shellfish) Peanuts Eggs Children Eggs Milk Peanuts 11 What Happens? Sensitized Individual comes in contact with food allergen Allergy antibody immunoglobulin E (IgE) Produced & binds to mast cells Second exposure to allergen Antibody/Antigen binding triggers mast cell response Mast cells primarily located in nose, throat, lungs, GI tract & skin Histamine release Food allergy symptoms 12 2
Signs of Allergic Response Itching in mouth Swelling of mucosal membranes Dysphagia Dyspnea, wheezing N/V/D Hives Dizziness Anaphylaxis * Reactions vary from person to person 13 Anaphylaxis against protection Severe allergic response Develops rapidly Can be fatal if not treated Persistent cough with airway swells, blood pressure drops, tachycardia, loss of consciousness Resulting in shock 14 Anaphylaxis Reaction can be mild and fade May need to use medication Late phase reaction Initial improvement followed by recurrence of symptoms Persistent reaction Hospitalization required Primary Intervention Educate Know the common allergens Seek medical attention if redness, itching, hives, difficulty breathing follows food intake Children with eczema or asthma more likely to have food allergies Comprehensive food labeling law Food label states whether it contains a major food allergen (Food Allergen Labeling & Consumer Protection Act of 2004) 15 16 Diagnosing Allergies Skin test Extract made from food placed on arm Positive reaction if raised bump develops in 20 minutes Blood test Identify antibodies to certain foods Food challenge Food consumed in medical setting Monitor for anaphylaxis Allergy Management NO CURE for food allergies Identify & avoid triggers Read food labels Wear a medical alert bracelet/necklace Carry an epinephrine pen Seek medical attention immediately if you have a food allergic reaction 17 18 3
Be Proactive Epinephrine Bring your own food to social events or parties Be aware of unintentional exposure Understand cross contact Can occur before, during or after production Some labels will state risk for cross contact produced in a plant that processes peanuts Join a list serve and receive press releases http://www.fda.gov/safety/recalls/ucm258317.htm EpiPen 0.3 mg EpiPen Jr Auto-Injectors 0.15 mg Indications Type 1 allergic reactions (anaphylaxis, allergens, exercise-induced anaphylaxis) Only injected in the anterolateral thigh! May precipitate angina or dysrhythmias A/E: tremors, palpitations, sweating, weakness 19 20 Epinephrine Pens Works on alpha and beta receptors: Lessens vasodilation and vascular permeability Relaxes smooth bronchial muscles, alleviates pruritus, urticaria & angioedema Keep away from light Discard if discolored Inject IM or subq into anterolateral thigh Parting Points Instruct parents to see an allergist if their child develops pruritus, swelling, redness of skin or trouble breathing after coming into contact with certain foods Be aware of cross contact Allergenic foods incorporated into other foods during manufacturing 21 22 regarding food allergies is true? 1. Children can outgrow allergies to food 2. Adults almost always outgrow food allergies 3. The number one food allergy is eggs 4. Almost everyone has a food allergy Which of the following is not considered a common food allergy? 1. Almonds 2. Soy 3. Peanuts 4. Mustard 23 24 4
The nurse is caring for a client who presents with an anaphylactic reaction. Which of the following signs is most likely to be observed? 1. Extreme elevation in blood pressure 2. Extreme eyelid edema 3. Extreme elevation in immunoglobulin G 4. Extreme facial pallor best describes an allergen? 1. A foreign substance that causes an allergic response 2. A foreign substance that results in an anaphylactic response 3. A foreign substance that blocks sensitization 4. A foreign substance that results in the overproduction of red blood cells 25 26 When a client has an anaphylactic reaction you should know that the quicker the symptoms begin, the 1. quicker the reactions will subside 2. worse the reactions will likely be 3. longer the duration of reactions 4. more milder the reactions will be regarding epinephrine pens is true? 1. Instruct clients to inject epinephrine pens into the deltoid or vastus lateralis muscle 2. Epinephrine should be discarded if it turns from brown to slight yellow 3. Epinephrine works by opposing vasodilation 4. Instruct clients that they should lie down and rest after using an epinephrine pen 27 28 Organizations Food Allergy & Anaphylaxis Network http://www.foodallergy.org/ References Chang, H. J. (2010). Food Allergies. Journal of the American Medical Association, 303(18). Retrieved from http://jama.amaassn.org/content/303/18/1876.full.pdf Pongdee, T., (2011). Getting the facts on food allergy testing. American Academy of Allergy Asthma & Immunology. (2011). Retrieved from http://www.aaaai.org/aaaai/media/medialibrary/pdf%20docum ents/libraries/el-food-allergies-testing-patient.pdf U.S. Food and Drug Administration. (2010). Food allergies: Reducing the risks. FDA Consumer Health Information. Retrieved from http://www.fda.gov/downloads/forconsumers/consumerupdates /UCM170952.pdf 29 30 5
References Gupta, R., Schuval, S. (2011). One in 12 U.S. children may have food allergies: Report. MedlinePlus. Retrieved from http://www.nlm.nih.gov/medlineplus/news/f ullstory_113390.html 31 6