NCM 109 – FINALS
through the skin. Common allergic
Allergy
Definition
 Allergies are abnormal immune
system reactions to things — known
as allergens —that are typically
harmless to most people. This causes
symptoms that can range from just
annoying to posmsibly life-threatening.
Common allergens include some foods,
dust, plant pollen, and medicines.
 occurs when a person reacts to
substances in the environment
that are harmless to most people
. 
WHAT YOU NEED TO KNOW?
 Allergies are the result of your
immune system’s response to a
substance.
 Immune responses can be mild, from
coughing and a runny nose, to a life-
threatening reaction know as
anaphylaxis.
 A person becomes allergic when
their body develops antigens against
a substance. Upon repeated exposure
the severity of the reaction may
increase.
 Allergies affect people of all ages,
races, genders and socioeconomic
statuses.
How does a person become allergic?
Allergens can be inhaled, ingested, or enter
reactions, such as hay fever, certain types of
asthma, and hives are linked to an antibody
produced by the body called
immunoglobulin E (IgE). Each IgE antibody
can be very specific, reacting against certain
pollens and other allergens. In other words,
a person can be allergic to one type of
pollen, but not another. When a susceptible
person is exposed to an allergen, the body
starts producing a large quantity of similar
IgE antibodies. The next exposure to the
same allergen may result in an allergic
reaction. Symptoms of an allergic reaction
will vary depending on the type and amount
of allergen encountered and the manner in
which the body's immune system reacts to
that allergen.
Allergies can affect anyone, regardless of
age, gender, race, or socioeconomic status.
Generally, allergies are more common in
children. However, a first-time occurrence
can happen at any age, or recur after many
years of remission. Hormones, stress,
smoke, perfume, or environmental irritants
may also play a role in the development or
severity of allergies.
Classification
When your body is hypersensitive to certain
stimuli, its negative response can be
classified into four distinct types of allergic
reaction:
TYPE I: anaphylactic reactions
are the most common allergic responses and
are triggered by allergens like pollen, dust
mites, animal dander, and certain foods.
Common anaphylactic reactions include:
 Food allergy
  Skin Allergy
 Allergic Rhinitis
 Asthma
Type II: cytotoxic reactions.
occur when IgG or IgM antibodies bind with
antigens on the cell surfaces. This causes a
chain of reactions that leads to cell death,
with symptoms occurring after minutes or
hours of exposure to the allergen.
Type II reactions cause conditions like:
 Autoimmune hemolytic anemia
 Immune thrombocytopenia
 Autoimmune neutropenia
 Goodpasture syndrome
 Graves’ disease
 Myasthenia gravis
Type III: immunocomplex reactions
are also linked to IgG and IgM antibodies.
When these antibodies bind with antigens,
they form immunocomplexes that settle on
tissues and organs. The body’s attempt to
remove these complexes damages the
underlying tissue.
Symptoms set in after several hours of
exposure. Examples of Type III allergic
reactions include:
 Rheumatoid arthritis
 Lupus
 Serum sickness
 Arthus reaction
Type IV: cell-mediated allergic reactions
are also called the delayed type of allergic
reactions because symptoms manifest at
least 24 hours after contact with the
allergen. Oftentimes, an allergic reaction
won’t occur until 48-72 hours after
exposure.
Type IV allergic reaction examples include:
 Tuberculin reactions
 Chronic asthma
 Contact dermatitis
 Fungal infections
Each one is triggered in different ways and
can manifest differently in each person.
Causes
Allergens can get into your body many ways
to cause an allergic reaction.
 You can inhale allergens into
your nose and your lungs.
- Many are small enough to
float through the air.
Examples are pollen, house
dust, mold spores, cat and
dog dander and latex dust.
 You can ingest allergens by
mouth.
- This includes food and
medicines you eat or
swallow.
 Your body can have allergens
injected into it.
- This includes medicine given
by needle and venom from
insect stings and bites.
 Your skin can absorb
allergens.
- Plants such as poison ivy,
sumac and oak can cause
reactions when touched.
Latex, metals, and
ingredients in beauty care and
household products are other
examples.
-
Clinical Manifestation provider might suggest nonprescription
or prescription medication in the form of
Symptoms of an Allergic Reaction The pills or liquid, nasal sprays, or eyedrops.
severity of symptoms during an allergic
reaction can vary widely. Some of the  Immunotherapy.
symptoms of an allergic reaction include: For severe allergies or allergies not
completely relieved by other treatment,
 Itchy, watery eyes your provider might recommend
 Itchy nose allergen immunotherapy. This treatment
 Sneezing involves a series of injections of purified
 Runny nose allergen extracts, usually given over a
 Rashes period of a few years.
 Hives (a rash with raised red
patches) Another form of immunotherapy is a
 Stomach cramps tablet that's placed under the tongue
 Vomiting (sublingual) until it dissolves.
 Diarrhea Sublingual drugs are used to treat some
 Bloating pollen allergies.
 Swelling Redness
 Pain  Emergency epinephrine.
 Tongue swelling If you have a severe allergy, you might
 Cough need to carry an emergency epinephrine
 Throat closing shot at all times. Given for severe
 Wheezing (a whistling sound when allergic reactions, an epinephrine shot
you breathe) (Auvi-Q, EpiPen, others) can reduce
 Chest tightness and losing your symptoms until you get emergency
breath treatment.
 Feeling faint, light-headed or
“blacking out”
 A sense of “impending doom” Nursing Management

Medical Management
Allergy treatments include:
 Allergen avoidance.
Your provider will help you take steps
to identify and avoid your allergy
triggers. This is generally the most
important step in preventing allergic
reactions and reducing symptoms.
 Medications.
Depending on your allergy, medications
can help reduce your immune system
reaction and ease symptoms. Your
 Assess any kind of allergy.
- The nurse must assess all
patients for allergies or previous
reactions to antigens.
-
 Assess patient’s knowledge.
- The nurse must also assess the
patient’s understanding of
previous reactions and steps
taken by the patient and the
family to prevent further
exposure to antigens.
 New allergies.
- When new allergies are
identified, the nurse advises the
patient to wear or carry
identification that names the
specific allergen or antigen.