1

I. INTRODUCTION

Background of the Study

Allergy is described as an exaggerated response from the body’s immune

system to otherwise inert substances present in the environment. Allergy is a broad
topic and speaks to the body’s immune response to foreign substances common in the
environment, and triggers a reaction from the body’s immune response described as
hypersensitivity (Vander et al., 2018)

Hypersensitivity is an inappropriate immune response to common, typically

harmless antigens, manifesting as a continuum from minor like atopic dermatitis and
rhinitis to severe manifestations such as anaphylaxis, anaphylactoid and asthma
(Fischer et al., 2018). Food allergy is defined as an immune reaction to proteins in the
food and can be immunoglobulin (Ig)E-mediated or non–IgE-mediated. IgE-mediated
food allergy is a worldwide health problem that affects millions of persons and
numerous aspects of a person’s life (Tang et al., 2018). Allergic reactions secondary to
food ingestion are responsible for a variety of symptoms involving the skin,
gastrointestinal tract, and respiratory tract. Prevalence rates are uncertain, but the
incidence appears to have increased over the past three decades, primarily in countries
with a Western lifestyle (Loh et al., 2018). Branum et al., (2008) of University of
Nebraska Food Allergy Research and Resource Program recently found that the
symptoms of IgE-mediated reactions can involve the gastrointestinal tract, skin, or
respiratory tract. Gastrointestinal and cutaneous symptoms are among the more
common manifestations of IgE-mediated food allergies. Accordingly, common
gastrointestinal symptoms include abdominal cramps, nausea, vomiting, and diarrhea.

According to Food Allergy Research and Education Facts and Statistic (2017)
every three minutes, a food allergy reaction sends someone to the emergency room.
Research also found out that each year in the U.S., 200,000 people required
emergency medical care for allergic reactions to food. Studies published in 2018 and
2019 estimate the number of Americans of all ages who have convincing symptoms of
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allergy to specific foods: Shellfish: 8.2 million; Milk: 6.1 million; Peanut: 6.1 million; Tree
nuts: 3.9 million; Egg: 2.6 million; Fin fish: 2.6 million; soy: 1.9 million; sesame: 0.7
million.

Patient B, an 18 years old, who was rushed to the Correct Perfect Medical
Center on November 28, 2023 with a chief complaint of difficulty of breathing,
abdominal pain with a pain scale of 8/10. Prior to arrival, the emergency personnel
noted facial redness particularly around the eyes and mouth with diffuse and severe
urticaria on Patient B's arms, legs, and chest. The patient personally stated that he is
aware in the first place that he is allergic to shrimp. The symptoms started at a
thanksgiving celebration after his graduation, where he deliberately consumed shellfish,
specifically shrimp and without hesitation, his allergic reaction manifested severely and
became unbearable. We the students chose this case study to better understand the
manifestations and disease process of Allergy or Hypersensitivity Reaction specifically
in relation to Gastrointestinal Manifestation of Food Allergy.
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II. OBJECTIVES

The purpose of this study is to increase our understanding of food allergies as

student nurses by gathering enough data that may be used as a reference to improve
our attitudes and abilities in applying nursing procedures and managing food allergies.

These data will enable us to better care for patients who have experienced
allergic reactions by providing them with the information and critical thinking abilities
they need.

Specific Objectives:

At the end of this case presentation, the student nurses will be able to:

1. Present the patient’s data and family background

2. Discuss the developmental plan

3. Define the complete diagnosis of the patient.

4. Discuss the physical assessment

5. Explain the anatomy and physiology involved in a patient with Food allergy reaction.

6. Discuss the etiology and symptomatology; and pathophysiology.

7. Elaborate the doctor’s order as well as the diagnostic exam of the patient.

8. Identify the drugs administered to the patient with food allergy reaction and its

surgical procedure, if there’s any.

9. Develop a nursing theory and nursing care plan related to the patient’s condition.

10. Provide the summary, findings, and recommendations for better management

about food allergy reaction that will be helpful in the patient, patient’s family,

community, and future researchers.

11. Provide the definition of medical terms and references/bibliograph

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III. PATIENT’S DATA

Patient Code Name: Patient B

Age: 18 yrs. Old

Nationality: Filipino

Civil Status: Single

Occupation: Student

Sex: Male

Religion: Roman Catholic

Ward and Room Number: Nursing Station 1

Date of Admission: November 28, 2023

Vital Signs During Admission:

Blood Pressure: 110/80 mmHg Temperature: 36.2℃

Pulse Rate: 120 bpm Respiratory Rate: 30 bpm

O2Sat: 89% Weight: 48 kg

Height: 5’6

Date of Discharge: December 02, 2023

Chief Complaint: Ineffective breathing pattern, Abdominal pain, and Itchiness

Admitting Diagnosis: Allergic Reaction

Attending Physician(s): Dr. Torres

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IV. FAMILY BACKGROUND

Grandmother
(Mother side)
Grandfather - with hypertension
(Father side) and food allergy
- with asthma

Patient Father Patient Mother

- with hypertension - with allergic
food reaction

Patient
Brother
- with allergic
PATIENT food reaction
- with allergic food reaction

Family health history

As we all asset the patient all the information, data, and sources that we used to
assess the patient’s condition were directly received from the patient’s own health
history and the health histories of his family members.

Patient B stated that when he was 16 years old, he used to eat a lot of different
foods, especially chocolates and carbonated drinks. As a teenager, he was very active
in playing outside games. One day, when he got invited by his friend to a birthday party,
he became fascinated by a large amount of food. One dish caught his attention –
 6

creamy garlic shrimp. He ate a lot, and that was his first encounter with a food allergic
reaction. He suffered from mouth and throat itching, lip swelling, and skin reactions,
such as hives, watery eyes, and skin redness, along with difficulty breathing. He said he
almost died when that happened, and he was carried to the emergency department
where he was injected with epinephrine. As he was getting into puberty, according to
Patient B, he avoided eating shrimps and other certain foods that could trigger his
allergy, as advised by his doctor, to prevent such a life-threatening experience.

According to Patient B, his family members also have a history of allergies. His
grandfather on his father’s side manifested asthma, and his grandmother on his
mother’s side has a peanut allergy along with other allergies to certain foods. Patient B
is aware that his family members, including his mother and sibling, have a history of
food allergies. He mentioned that his mother used to be strict when it came to cleaning
the house and preparing foods. He also stated that his mother was overprotective of
them, being a housewife. Patient B can still recall the moment when his mother
accidentally ate peanut butter, suffering at that time from skin reactions, nausea, and
vomiting. He remembered that his mother had a prescription for palforzia, which she
used to take every time her food allergy was triggered. The patient’s younger brother,
still in elementary school, also shows signs of allergies. His father was the only member
of the family without allergies; he works as an engineer.

Effects/Expectations of Illness to self/family:

The patient was identified as having an allergic reaction to eating shrimp,

resulting in signs and symptoms such as difficulty breathing, skin redness, sudden
itching, lip swelling, watery eyes, hives, and skin redness. The hives caused the patient
to become itchy. Continuous medical care is necessary, involving expensive and time-
consuming procedures, medication, and regular checks for breathing patterns and skin
redness. The patient also experienced psychological and emotional effects, such as
distress and anxiety. According to the patient, there is fear about whether the condition
can be treated or not. The family is concerned about the patient's health, monitoring
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their condition regularly to determine if it is within normal limits.

The patient's family expresses concern about their loved one's health, stating
that food allergic reactions are easy to treat. On the mother's side of the patient, there is
a history of food allergies inherited from grandparents. As a result, they concentrate on
treating the patient's breathing pattern. They verbalize that it doesn't matter if they
spend a lot of time and money, as long as they can guarantee the patient's recovery
from this illness. In contrast, the patient believes they can overcome the sickness by
following the doctor's advice and relying on family support. The patient is confident in
recovery, adhering to medication, following the nurse's advice, and undergoing various
therapies for treating his allergies. The patient is committed to maintaining a healthy
lifestyle and avoiding allergic foods to ensure a full recovery.

Family members have confidence in the patient's ability to get well, witnessing
compliance with instructions and genuinely believing in the patient's efforts for a full
recovery. To provide the patient with necessary support, the family continues to assist
with everyday tasks, provide prescriptions, and ensure access to required medical
attention.

Client’s Health History

Past Health History

The patient had been identified as having an allergic reaction to food when he
was 16 years old, back in 2021. The doctor then gave him advice on how to treat food
allergies and live a healthy lifestyle, including eating healthier meals, avoiding allergic
food, and cutting back on restricted seafoods. Despite having these problems
diagnosed, the patient chose to disregard the results and carry on with his unhealthy
lifestyle habits, continuing to work because he wasn't experiencing any strange
symptoms at the time. Even though the patient had a history of allergy reaction, such as
eating a lot of allergic food and restricted favorite seafood. The patient was unable to
keep track of his trigger on craving allergic food at the same time, and he wasn't taking
any medications to keep it there.
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Present Illness/es

The patient's chief complaint of dyspnea, abdominal cramps accompanied by an

allergic reaction such as facial swelling and hives that are intensely pruritic and has
become unbearable that promptly made the mother rush him to seek medical attention
at the hospital. The patient is experiencing signs and symptoms of an anaphylactic
reaction, including difficulty of breathing, facial redness, and swelling to the point he
feels the intense itching throughout his entire body. Whenever he experiences difficulty
breathing, the mother would ask for assistance from the nurse, given the worried
situation he is currently facing. The patient has also expressed occasional scratching,
and in these instances, his mother, acting as the caregiver, prevents him from
scratching the itchy areas. She is there to manage the patient's emotions, balancing
irritation and calmness, particularly when the patient has watery eyes on his face.
 9

V. DEVELOPMENTAL DATA

ERIKSON PSYCHOSOCIAL THEORY

Theory Stages Justification and Result
Erikson's psychological Identity vs Confusion Based on the patient he was
theory proposed the playing basketball and video
human development that Age 12 - 20 games with his friends.
occurs in stages from (Adolescence) As they
childhood to old age. transition from childhood
According to him, the to adulthood, teens may
idea of what is known begin to feel confused or
about how we develop, insecure about
how our circumstances themselves and how they
are made, especially our fit into society. As they
families that affect our seek to establish a sense
lives, and why some of self, teens may
people experience experiment with different
identity crisis is related to roles, activities, and
how we build our behaviors. According to
personalities depending Erikson, this is important
on where we started to the process of forming
a strong identity and
developing a sense of
direction in life.
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SIGMUND FREUD’S PSYCHOSEXUAL DEVELOPMENT THEORY

Theory Stages Justification and Result
Sigmund Freud proposed Genital Stage The patient begins to explore
that personality his sexual feelings by going out
development in childhood Puberty - Adult on a date and going to parties.
takes place during five During this stage,
psychosexual stages, individuals start to Achieved
which are the oral, anal, become sexually mature
phallic, latency, and and begin to explore their
genital stages. sexual feelings and
During each stage, desires more maturely
sexual energy (libido) is and responsibly.
expressed in different
ways and through
different body parts
 11

PIAGET’S DEVELOPMENT THEORY

Theory Stages Justification and Result
Piaget proposed that Formal Operational As the patient reached the
cognition developed Stage puberty stage, he started to
through distinct stages understand that shrimp is life
from birth through the The final stage of Piaget's threatening for him, so he
end of adolescence. theory involves an started to avoid it.
Piaget proposed four increase in logic, the
major stages of cognitive ability to use deductive Achieved
development, and called reasoning, and an
them (1) sensorimotor understanding of abstract
intelligence, (2) ideas.3 At this point,
preoperational thinking, adolescents and young
(3) concrete operational adults become capable of
thinking, and (4) formal seeing multiple potential
operational thinking. solutions to problems and
Each stage is correlated think more scientifically
with an age period of about the world around
childhood, but only them.
approximately.
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VI. DEFINITION OF COMPLETE DIAGNOSIS

The patient was identified as having an allergic reaction to a certain food which
he has symptoms of difficulty breathing, skin redness, sudden itching and facial swelling
in the mouth and eyes. The patient appeared weak due to classical manifestation such
as difficulty of breathing this was confirmed by his lab results and the food intolerance
test which his blood sample appeared positive for allergies to shellfish with 126 U/ml
value, added on that is his skin prick testing which also an allergy testing resulted
positive of allergic reaction in food with a value of 6.5 mm in diameter.
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VII. PHYSICAL ASSESSMENT

Personal Data

Patient B is an 18 years old male admitted on November 28, 2023 with a chief
complaint of Ineffective breathing pattern, abdominal pain and facial redness.

General Survey

Received patient on bed coherence with ongoing IV infusion of Epinephrine at 1

mg/hr along with D5W 1 L 16 cc/hr on right metacarpal vein infusing well not in
respiratory distress (+) redness

Vital signs

-Temperature: 36.2℃ -RR: 30 cpm

-B/P: 110/80 mmHg -O2Sat: 89 %

-PR: 120 bpm -Weight: 48 kg -Height: 5’6

Appearance of the patient: Patient appeared weak due to classical manifestations

such as difficulty of breathing

Skin: The patient's entire body has signs of urticaria on the face, neck, chest arms, and
legs and pallor was noted.

Hair: His hair appears to be in black and curly. No signs of redness

Face: The patient's face is round asymmetrical with facial swelling noted.

Eyes and Vision: Eyebrows are symmetrically aligned. Upon inspection of corrective
lenses, pupils are mildly red and watery, reactive to light and in accommodation.
Patient’s visual acuity appeared weak due to his state.

Ears and hearing: Upon inspection, ears are symmetrically aligned with each other,
and are aligned with the outer canthus of each eye. No unusual discharge noted.
 14

Patient is cooperative when hearing questions.

Nose: Upon inspection, the patient’s nose is refined.

Mouth: The patient's outer lips are swollen and red.

Neck: (-) lymphadenopathy (LAD). No masses, lesions or any unusuality were noted.
Shoulder muscles had symmetry from an anatomical perspective. (+) Signs of urticaria.

Chest: Clear to auscultation. (+) Signs of urticaria.

Nails: The fingertips and toes of the patient appear pink. Epidermis surrounding the
nails was intact and trimmed; no lesions were noted.

Abdomen: (+) Signs of urticaria. The abdomen is soft, non-tender, and uncongested.
No scars or lesions can be seen.

Extremities: (+) Signs of urticaria. Full range of motion is noted to all joints.
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IX. ETIOLOGY AND SYMPTOMATOLOGY

ETIOLOGY
BASIC PRESENT RATIONALE ACTUAL
ETIOLOGY /
ABSENT
PRECIPITATING
FACTORS

Family History ✓ Individuals with a family The patient's mother

of Food Allergy history of allergic informed us that, in
reactions, such as addition to other
asthma and food symptoms, she and his
allergies, may face a other son both manifested
slightly higher risk of a food allergy.
developing a food Furthermore, she
allergy. Recognizing acknowledged the
this, there is a hereditary connection in
heightened focus on the family's health history.
food management. This
includes educating both
patients and caregivers
about food allergies
and providing self-
administration training.
These measures aim to
prevent allergic
reactions, enhance
safety, and foster a
confident and
empowered approach
to managing food
allergies

Age ✓ The genetic makeup The patient’s mother

affects both the mentioned his son
process of aging and attending a friend's
the development of birthday party, where he
allergies. As individuals was captivated by a
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age, changes in their variety of foods. His

immune system and
inflammatory
responses may occur,
potentially affecting
their susceptibility to
food allergies.
indulgence in creamy
garlic shrimp during the
event triggered his first
food allergic reaction.

SYMPTOMATOLOGY
SYMPTOMS PRESENT/ RATIONALE ACTUAL
ABSENT

Hives ✓ Hives, or urticaria, Our patient’s significant

result from the release other (S.O.) stated that
of histamine triggered before admission, one of
by allergens, foods, the chief complaints was a
medications, or other skin reaction
factors. This release characterized by red welts
causes itchy welts on that were very itchy.
the skin due to blood
vessel leakage.
Managing hives
involves identifying
triggers and may
require medical
intervention.

Difficulty of ✓ Difficulty in breathing Our patient's significant

Breathing during an allergic other (S.O.) stated that
reaction is due to the before admission, his
release of chemicals initial complaint was
like histamine. This difficulty in breathing,
causes airway characterized by an
inflammation and inability to breathe rapidly
constriction, leading to or deeply enough. This
respiratory symptoms. symptom became
Identifying triggers unbearable and led to the
 17

and seeking timely decision to seek medical

medical intervention attention at the hospital.
are essential for
management.

Abdominal Pain ✓ Abdominal pain in Our patient's significant

allergic reactions is other (S.O.) stated that
primarily due to the before admission, his
release of initial complaint was
inflammatory difficulty in breathing,
mediators like characterized by an
histamine, causing inability to breathe rapidly
smooth muscle or deeply enough.
contraction, increased
sensitivity of nerve
endings, inflammation,
and potential disruption
of normal digestive
processes.

Swollen Lips ✓ Swollen lips in an Our patient stated that his

allergic reaction stomach started to ache
happen due to after eating a lot of shrimp
increased blood flow in thanksgiving.
and fluid accumulation
triggered by allergens,
leading to
inflammation.

Watery Eyes ✓ Watery eyes in Our patient’s significant

allergies also occur other (S.O.) stated that
when the immune prior to admission the
system releases mother is present to
histamine, prompting provide comfort, even
increased tear though the patient was
production. This feeling irritated due to his
response is the body's watery eyes.
attempt to flush out
allergens
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X. PATHOPHYSIOLOGY
 19

XI. DOCTOR’S ORDER

Date Ordered Doctor’s Order Rationale Remarks

11/28/23 Admit pt under ER DEPT For a high standard Done
8:25 AM of care for severe or
sudden emergency
treatment.
Secure consent Patient has the right Done
to be consented in all
procedures to
bedone
TPR with BP q4 To monitor vital signs Done
so that any
 20

unusualities will be
referred as follows
Done
● IM epinephrine @ Epinephrine: To treat
0.5 mg/min very serious allergic
reactions to insect
stings/bites, foods,
drugs, or other
substances. And
quickly improve
breathing, stimulate
the heart, raise a
dropping blood
pressure, reverse
hives, and reduce
swelling of the face,
lips, and throat.

IVF:
● D5W 2 L at 16cc/hr IV: D5W – A solution
● IV infusion: that helps to replace
Epinephrine @ 5 lost fluids and
ml/hr provide
carbohydrates to the
body.
Start O2 at 8 L/min via To provide a method Done
facemask to transfer breathing
oxygen gas from a
storage tank to the
lungs.
Laboratory: CBC with PC Done
CBC PC determines the
quantity of each
quantity of blood cell
in a given specimen
of blood,often
including the amount
of hemoglobin,
hematocrit, and the
proportion of various
white blood cells. To
know any deviations
or abnormalities in
the blood
Rapid Antigen Test To detect certain viral Done
antigen, in which
 21

recent cases of
SARS-CoV-2
Blood Test: A test that examines Done
● Sodium (Na) the cells, chemicals,
● Potassium (K) proteins or other
● Calcium (Ca) substances in the
● Magnesium (Mg) blood.
● Albumin
● Creatine
● BUN,
● SGPT,
● HGT
Urinalysis To screen patient's Done
urine for renal/urinary
detect substance
Skin Prick Test To detect IgE
mediated type I
allergic reactions like
allergic rhinitis, atopic
asthma, acute
urticaria, food allergy
etc.
Food intolerance Test To identify whether Done
your body is
hypersensitive
towards a certain
food, which could
cause an adverse
reaction to your
system.
Allergen Specific IgE Test To diagnose and Done
better manage food
allergies.
Medication: To treat sneezing, Done
● Benadryl 25 mg runny nose, watery
over 15 min every eyes, hives, skin
4 hours rash, itching, and
other cold or allergy
symptoms.
● Methylprednisolone A corticosteroid Done
10 mg every 6 medication to
hours decrease the immune
system's response to
various diseases to
reduce symptoms
such as swelling,
 22

pain, and allergic-

type reactions.
● Famotidine 20 To treat stomach Done
mg/day every 12 ulcers (gastric and
hours duodenal), erosive
esophagitis
(heartburn or acid
indigestion), and
gastroesophageal
reflux disease
(GERD).
I/O every shift To indicate the fluid Done
balance for the
patient
11/29/23 Follow up lab results -
7:50 AM
Continue IVF at same rate IV: D5W – A solution Done
that helps to replace
lost fluids and
provide
carbohydrates to the
body.
V/S every 4 hours of HR To have a baseline Done
and SO2 data and to assess
the heart rate and
oxygen saturation of
the patients health
status.
11/30/23 Shift benadryl to cetirizine An antihistamine Done
8:30 AM HCI 10 mg PO once daily medicine that helps
the symptoms of
allergies. It's used to
treat: hay fever.
conjunctivitis (red,
itchy eye)
I/O every shift To indicate the fluid Done
balance for the
patient
Refer back as needed To refer to any Done
casualties and
maintain professional
accountability
towards physicians
and other healthcare
staff.
 23

12/01/23 Repeat Allergen Blood To diagnose and

9:20 AM test better manage food
allergies.
D/C oxygen mask shift to To relieve symptoms
inhalation: Salbutamol 1 such as chest
neb every 4 hours tightness, wheezing,
shortness of breath
and coughing in
some other chest
diseases too, such as
COPD
Continue medication
12/01/23
10:00 AM No objective from
psychology service for
discharge:

Secure bill for possible

discharge

XI. DIAGNOSTIC EXAM

LABORATORY RESULT

URINALYSIS

Date Ordered Test Patient’s Result

November 28, 2023 URINALYSIS Physical Examination

◆ Color: Yellow
 24

◆ Sugar: Negative

◆ Transparency: Clear

◆ Albumin: 1+

◆ Reaction: 7.0

◆ Specific Gravity:
1.010

RBC: 5-10
WBC: 2-5

FECALYSIS

Date Ordered Test Patient’s Result

November 28, 2023 FECALYSIS MACROSCOPIC

RESULT:

Color: Brown
Consistency: Soft
MICROSCOPIC
RESULT
No Ova/Intestinal
Parasite Seen

SEROLOGY

TEST KIT USE METHOD RESULT

HBsAG ADVANCE QUALITY RAPID TEST NON-REACTIVE

(Qualitative) HBsAg ONE STEP
HBsAG TEST
(SERUM/PLASMA)
 25

COVID-19 RAPID ANTIGEN TEST

Date Exam Result Interpretation

A negative COVID-
Nov. 28, COVID-19 RAPID NEGATIVE 19 test means the
2023 ANTIGEN TEST test did not detect the
(ICHROMA) virus.

CLINICAL CHEMISTRY REPORT

Date Test Patien Normal Clinical Nursing

Ordered t’s Value Significance Responsibilitie
Result s

November URIC 160.46 155 - The patient’s

28, 2023 ACID umol/L 357 Uric Acid level
umol/L is The results
160.46 umol/L
shows a
normal value.

November SGPT 23.02 4-34 U/L The patient’s

28, 2023 U/L SGPT level is
23.02 U/L.
The results
show a normal
value.

SERUM ELECTROLYTES

Date Test Patient’s Normal Clinical Nursing

 26

Ordered Result Value Significanc Responsibilities

e

November Sodiu 144.7 135-148 The patient’s

29, 2023 m mmol/L mmol/L Sodium level
(Na+) is 144.7
mmol/L. The
results show
a normal
value.

November Potass 7. 34 3.50- The patient’s

◆ Administer
29, 2023 ium mmol/L 5.30 Sodium level
(K+) (H) mmol/L is 7.34 medications
mmol/L as
where the prescribed
normal value ◆ Monitor Ins
level is and Out
within the
range of ◆ Assess the
3.50-5.30 patient for
mmol/L. The signs and
results show symptoms of
abnormality. toxicity
◆ Educate the
patient
related to
diet

November Calciu 1.10 1.13- The patient’s

29, 2023 m mmol/L 1.32 Sodium level
(Ca++) mmol/L is 1.10
mmol/L. The
results show
a normal
value.

November Chlori 113.0 98-107 The patient’s

◆ Administer
29, 2023 de mmol/L mmol/L Chloride
(Cl-) level is medications
 27

(H) 113.0 as
mmol/L prescribed
where the
normal value
◆ Educate the
level is
within the patient
range of 98- related to
107 mmol/L. diet and
The results hydration.
show
abnormality. ◆ Obtain
accurate I&O

◆ Monitor labs

COMPLETE BLOOD COUNT

Date Test Patient’s Normal Clinical Nursing

Ordered Result Value Significanc Responsibilitie
e s

Nov. 29, Hemog 147 g/L 110-150 The patient’s

2023 lobin g/L Hemoglobin
4:09 PM level is 147
g/L. The
results show
a normal
value.

Hemat 50% 37.0 - The patient’s

◆ Encourage
ocrit (H) 48.0 % Hematocrit
level is 50% the patient to
where the stay
normal value hydrated
level is ◆ Educate the
within the patient to
range of avoid
 28

37.0-48.00 smoking,
%. The limit alcohol
results show consumption
abnormality.
◆ Encourage
Signs and
symptoms of the patient to
headache, exercise
feeling light- regularly
headed, ◆ Monitor I and
shortness of O
breath,
fatigue, skin ◆ Monitor VS
symptoms for baseline
such as data
itching,
burning or
red face,
heavy
sweating,
blurred or
double vision
and blind
spots.

RBC 4.80 4.50- The patient’s

mmol/L 5.00 RBC level is
mmol/L 4.80 mmol/L.
The results
show a
normal
value.

MCV 92.7 fL 80.0- The patient’s

100.0 fL MCV level is
92.7 fL. The
results show
a normal
value.
 29

MCH 33.3 pg 27.0- The patient’s

34.0 pg MCH level is
33.3 pg. The
results show
a normal
value.

MCHC 359 g/L 310-370 The patient’s

g/L MCHC level
is 359 g/L.
The results
show a
normal
value.

WBC 14.22 4.00 - The patient’s

◆ Provide
10^9/L 12.00 WBC count
(H) 10^9/L is 14.22 baseline
mmol/L assessment
where the of pulmonary
normal value and
level is neurological
within the function
range of
4.00-12.00 ◆ Assess the
mmol/L. The general
results show condition of
abnormality. the patient
Signs &
Symptoms of
fatigue, pain ◆ Closely
rash, monitor the
difficulty lab value
breathing
that cause
◆ Provide
leukocytosis.
psychologica
l support

Neurtr 40.0 - The patient’s

 30

ophils 92.0% 70.0% Neutrophils

◆ Administered
(H) count is 92%
where the medication
normal value as
level is prescribed
within the
range of 40- ◆ Provide
70%. The patients with
results show relaxation
abnormality. and calming
Usually techniques.
happens
when the
body ◆ Provide rest
consumes to patient
immune cells
more quickly
than it
creates them
or when the
bone marrow
is creating
them
improperly
meaning the
body is
under stress.

Lymph 6.5% 20.0- The patient’s

◆ Educate the
ocytes (L) 40.0% Lymphocyte
s patients to
count is follow a
6.5% where healthy diet
the normal plan, get
value level is plenty of
within the rest, and
range of 20- practice
40%. The hygiene.
results show ◆ Administered
 31

abnormality. medications
Meaning to as
say that the prescribed.
patient is at
the higher
◆ Teach the
risk of
infection. patient to eat
foods rich in
omega 3
fatty acids to
increase
lymphocytes

Monoc 1.5% 3.0- The patient’s

◆ Educate the
yte (L) 12.0% Monocyte
count is patient to
1.5% where practice a
the normal healthy
value level is lifestyle to
within the boost the
range of 3.0- immune
12.0%. The system.
results show
abnormality. ◆ Teach
Tend to patient to
develop as a maintain a
result of good rest.
medical
conditions
that lower ◆ Encourage
the overall patients to
white blood exercise
cells count regularly.
or disease
treatments
◆ Teach
that
suppress the patient to eat
immune diet high in
system. fruits and
vegetables.
 32

Eosino 9.0 % 0.5- The patient’s

◆ Administered
phils (H) 5.0% Eosinophils
Count is medication
6.0% where as
the normal prescribed
value level is ◆ Educated the
within the patient
range of 0.5- regarding
5.0%. The healthy
results show lifestyle
abnormality.
High ◆ Monitor vital
eosinophil signs for sign
numbers of infection
may indicate
◆ Monitor for
mild
conditions early signs of
such as a localized and
drug reaction systemic
or allergy, or infection for
a severe patients
condition
could cause
it, including
some blood
disorders.

Basop 0.0 0.0-1.0 The patient’s

hils Hemoglobin
level is 0.0
The results
shows a
normal
value.

198 150-350 The patient’s

 33

Platele 10^9/L 10^9/L Platelet level

t is 198
10^9/L.
The results
shows a
normal
value.

FOOD INTOLERANCE TEST

Test Report: Order of Reactivity

TEST KIT USE VALUE INTERPRETATION

Blood Sample FOOD Order of Elevated Food

INTOLERANCE Reactivity: Detected. IgG
TEST antibodies detected
126 U/ml = against sample food.
Shellfish Positive for Allergens
to Shellfish.

Color Coding: RED

SKIN PRICK TEST

Allergy Testing

TEST KIT USE VALUE INTERPRETATION

Skin Prick High Precision Wheal 6.5 mm There is a POSITIVE

Allergy Skin Prick Kit in diameter response to food
Testing Testing allergen, with a wheal
6.5 mm in diameter.
No reactions to other
substances are noted.
 34

XVI. DISCHARGE PLAN (M.E.T.H.O.D)

Medication. Carefully explain to the patient the prescribed drug action, time, schedule,
side effects and adverse reactions. Do not take any other drugs, supplements, vitamins,
or herbs without asking the provider about them first.

Exercise. Patients should perform minimal activities.

Treatment. Avoid exposure to the food altogether. If the patient eats food and has a mild
reaction, over-the-counter antihistamines may help relieve symptoms and if the patient
has a more severe reaction as well as any signs and symptoms of anaphylaxis may be
used to prescribe medication like adrenaline.

● antihistamines – used to treat mild to moderate allergic reactions.

● adrenaline – used to treat severe allergic reactions (anaphylaxis)

Health Teaching. Instruct the patient to regularly monitor his food intake especially to
the food that may be able to trigger her allergy. Emphasize the value of rest, lead a
healthy lifestyle, and attend medical checkups, as well as doing as the doctor
prescribes.

Outpatient. Keep a follow-up appointment. Close follow-up is important to stroke

rehabilitation and recovery.

Diet. Instruct to eat more fiber containing fruits and vegetables. Maintaining a proper
diet is essential for long-term relief. Allergies can be managed through identifying
dietary triggers and eliminating them from the diet.
 35

XVII. RECOMMENDATION

Based on the outcome of this study, the following will benefit:

Community. This study will be helpful and intended to the most appropriate kinds
of community programs to share the source of information for those interested in
gaining a greater understanding of the knowledge of Allergy, its symptoms, causes, and
treatments.

Patients. The patients must consult with a health care practitioner for complete
information about their health, medical concerns, and treatment options. They must be
fully informed on the condition to decide which treatments and interventions are most
appropriate for the patient. Additionally, this study might help the reader understand
what changes they should make or what behaviors they should avoid.

Nurses. This study is important for nurses because it will serve as a guide for
them to give scientifically valid measurements of knowledge and performance
competencies through clients with varying degrees and types of educational preparation
and experiences.

Future Researcher. The study's results were used as a source of information and
a manual for future researchers who wished to carry out the same study or any study
concerning Allergy patients.
 36

XVII. REFERENCE/BIBLIOGRAPHY

● Branum AM, Lukacs SL. 2008. Food allergy among U.S. children: trends in
prevalence and hospitalizations. NCHS Data Brief:1-8.
● Food Allergy Research and Education. Facts and Statistics. NCHS Data Brief:1-
8. 2017 Oct 21; 14(4)
● Fischer D, Vander Leek TK, Ellis AK, Kim H. Anaphylaxis. Allergy Asthma Clin
Immunol. 2018;14(Suppl 2):54.
● Loh W, Tang MLK. The Epidemiology of Food Allergy in the Global Context. Int J
Environ Res Public Health. 2018 Sep 18;15(9)
● Tang MLK, Loh W. The Epidemiology of Food Allergy in the Global Context. Int J
Environ Res Public Health. 2018 Sep 18;15(9)
● Vander Leek TK, Fischer D, Ellis AK, Kim H. Anaphylaxis. Allergy Asthma Clin
Immunol. 2018;14(Suppl 2):54.