Latex Allergy Nursing Diagnosis and Nursing Care Plan
Latex Allergy Nursing Care Plans Diagnosis and Interventions
The use of latex and latex gloves is pervasive in the hospital setting; nevertheless, its usage has been reported to cause allergies in the general public. Natural latex rubber is extracted and produced from the saps of rubber trees (Hevea brasiliensis) and is used to manufacture hospital instruments such as catheters and surgical gloves. Therefore, the prevalence of latex sensitization or reactions to latex is predominantly linked to healthcare practices or sources.
The alarming increase of latex allergy reactions upon contact to allergic latex protein has left many individuals, even health workers, predisposed and at risk of developing severe latex induced anaphylaxis. If not appropriately managed, serious reactions can be life-threatening, especially if contact with latex is prolonged and persistent.
Signs and Symptoms of Latex Allergy Response
There is no difference between the clinical manifestations of patients to occupational exposure of healthcare workers. Usually, latex allergy is characterized by rashes or hives. Health care workers frequently exposed to latex airborne particles and aerosolized latex proteins may develop asthma and allergic rhinitis. Other allergic response manifestations include the following:
- Positive puncture/skin test to natural rubber latex (NRL)
- Intraoperative anaphylaxis
- Presence of swelling in the face, skin, and subcutaneous tissue
- Presence of pruritis or having an itchy, reddish skin
- Dyspnea – Difficulty breathing
- Irritant contact dermatitis
Causes and Risk Factors of Latex Allergy Response
The prevalence of latex allergies in health care facilities has been linked to its regular usage of wearing gloves among health care professionals, from physicians, nurses, laboratory workers, and so forth. Additionally, latex application in the health care setting enhances risk to sensitization among exposed patients—thereby causing latex allergy response.
- Direct exposure to latex – direct contact with latex gloves, catheters, or condoms is the most common and conventional form of induced latex allergy. Its outcome is directly proportional to the amount of allergen exposure and sensitization.
- Transfer of allergen – food handlers using latex gloves are also vehicles for latex allergen transfer. The powdered latex gloves can contaminate the food preparation or handling process; thus, causing a reaction to sensitized individuals.
- Airborne particulates of latex allergen – powders coming from the rubber latex are easily transmissible when it has been suspended in the air. Hence, patients or individuals who are already sensitized may inhale the particulate allergen, causing an allergic reaction.
Occupational allergy exposure is one of the predisposing factors in developing latex allergy. Additionally, patients who may have undergone numerous medical procedures have an increased risk of sensitization; other specific risks factors attributed to latex allergy include:
- Individuals with spina bifida
- Patients with repeated corrective surgeries and medical procedures
- Frequent catheterization because of urological anomalies
- Food allergies
- Regular exposure to latex-containing medical equipment or instruments
Diagnosis of Latex Allergy Response
Latex allergy can often be mistaken for allergic contact dermatitis; therefore, diagnosis is strongly reliant on its clinical manifestations and triggers. It may manifest varying signs and symptoms, depending on the type of hypersensitivity—for latex allergy, skin presentations such as rashes and hives after exposure to latex indicate this condition. Other tests which may be employed are the following:
- Blood tests
- Skin prick/puncture test – the gold standard for screening latex allergy, it can also detect asymptomatic patients.
- Serological testing of serum IgE
Treatment for Latex Allergy Response
There is no precise treatment for latex allergy response other than prevention and management of its signs and symptoms. But in cases of severe allergic reactions, treatments include the following:
- Supportive care. Prompt removal of latex allergy triggers for patients suffering from immediate type 1 hypersensitivity. If the reaction is severe, watchful care from healthcare providers may be required.
- Medications. Drugs are used to control the itching sensation, inflammation, and redness, as evidenced by latex allergy. Other than oral medications, topical creams such as steroids are prescribed by a dermatologist to control and manage these skin manifestations. If allergic reactions become severe, medications in the event of anaphylaxis may be required.
Nursing Care Plan for Latex Allergy Response
Latex Allergy Nursing Diagnosis
Impaired Skin Integrity
Ineffective Airway Clearance related to hypersensitivity to latex
|Nursing Interventions for Latex Allergy||Rationale|
|Ensure the patient is relaxed and comfortable during the initial assessment. Guarantee patient confidentiality and ensure any shared statements will only be shared among handling health workers.||To assure that the patient’s confidentiality is not implicated. To allow space for integrity and openness of the situation.|
|Assess the patient’s medical history and document his/her physical status.||Management and diagnosis always start with assessment and documentation of the patient’s medical history and physical well-being. This is performed to ensure diagnosis will be made accurate and inadvertent problems will be avoided during the treatment plan.|
|Ask the patient if he/she has any history of food allergy.||Individuals who have food allergies to fresh vegetables and fruits (e.g., apple, banana, carrot, avocado, etc.) are likely to develop latex allergy reactions. This happens because of latex cross-reaction with hevamine chitinase found in fruits.|
|Ask the patient about prior exposure to latex during dental procedures, surgery, or any medical procedures.||Establishing known latex allergy helps determine the appropriate management plan to implement. This also notifies handling medical workers of the patient’s susceptibility to latex and similarly prevents latex exposure when the patient will be undergoing any test or medical treatment.|
|Assess the patient’s skin, correlate the patient’s medical history with the signs and symptoms, and determine if it’s latex allergy or allergic contact dermatitis.||To determine that the patient’s condition is caused by latex allergy rather than allergic contact dermatitis. The skin manifestations resulting from latex allergy can often be mistaken for allergic contact dermatitis, both of which are characterized by distinct erythema of the skin. The difference is that latex allergy is attributable to Type I immediate hypersensitivity reaction whereas, in allergic contact dermatitis, the appearance of erythema is caused by a delayed-type IV hypersensitivity reaction. In addition, latex allergy would have accompanying signs and symptoms of asthma, itchiness, angioedema, and systemic response. On the other hand, allergic contact dermatitis would have accompanying signs and symptoms of itching (pruritus) and hives.|
|Assess the patient’s skin in his/her entire body and examine the affected areas.||To determine the severity of the latex allergy reaction.|
Nursing Planning and Intervention
|Nursing Interventions for Latex Allergy||Rationale|
|Educate the patient about latex allergy as well as the signs and symptoms to be wary of.||It is necessary to inform the patient about the condition to provide an overview of the possible risks and complications involved upon exposure to latex or allergic latex proteins.|
|Educate the patient to avoid products containing latex and carefully read product labels that might contain latex allergen.||The nurse will teach and safeguard the patient from possible exposure to latex. This helps the patient recognize harmful products that may trigger an allergic reaction.|
|Verify and document known latex allergy of the patient using screening tests: |
Skin prick test
Serum IgE immunoassay
Temporal correlation of clinical symptoms
|The nurse should screen the patient for known latex allergy response to ensure that the management plan is aligned with the type of reaction. There are varying types of latex allergy, and it is important to stress on which specific reaction the patient exhibits since type IV hypersensitivity may require topical creams as opposed to type I that requires immediate medical attention.|
|The handling nurse or healthcare workers will only use latex-free medical equipment and its alternatives: Polyvinyl chlorideSiliconeNeoprene||The patient’s exposure to latex should be limited as much as possible; this is done to ensure the safety of the patient and prevent an allergic reaction. Health care providers and hospitals will need to employ non-latex gloves and equipment so as not to threaten the patient’s welfare. Similarly, the patient will have to identify and avoid latex-containing items and products.|
|Ensure that the patient’s environment is latex-free.||To prevent exposure to allergic latex proteins or latex aerosols present in the environment.|
|Encourage the patient to wear a medical alert wristband.||This helps by alerting others of susceptibility to latex.|
|In case the patient has a history of anaphylaxis, always have available resuscitation equipment inside the room or near the patient’s bedside.||Anaphylaxis is life-threatening, especially if not addressed immediately. It is essential to secure availability and access to medical equipment (e.g., resuscitation equipment) since anaphylaxis can drastically worsen in a matter of minutes. Likewise, being prepared allows a more rapid response.|
|In the event of anaphylaxis, remove any triggers, seek help and inform the handling physician or resident physician, administer the appropriate medication.||Immediate identification of the patient’s triggering factors will help counteract its drastic after effects. However, there are cases when there are no obvious allergens during anaphylaxis; thus, administration of appropriate medication help alleviate symptoms and minimize the risk of developing further complications.|
|Administer topical steroids (as prescribed by a dermatologist) in the event of inflammation.||The use of topical steroids is one of the ubiquitous treatments for latex reactions and contact dermatitis. It acts by reducing inflammation and has a thinning effect on the skin.|
|If the type of latex allergy reaction is due to irritant dermatitis, immediately remove any present latex and cleanse the affected area with water.||To ease the affected site and decrease the inflammatory response.|
|Nursing Interventions for Latex Allergy||Rationale|
|Evaluate the patient’s behavioral response to the nursing interventions.||To determine the effectiveness of the nursing interventions and education on latex allergy response.|
|Evaluate the patient’s mental status in relation to care and management.||To evaluate the patient’s response to treatment.|
|Assess the patient’s breathing coordination, oxygenation, and listen for any abnormal wheezing.||To ensure that the reaction has stopped and there is no possible development of latent complications.|
|Monitor the patient’s skin for redness, presence of rash, and observe for wheal formation.||To ensure that the patient’s mild reactions would not progress to an even serious and deadly scale.|
|Monitor the patient for any obvious signs and symptoms of an imminent anaphylactic reaction, document the patient’s vital signs.||For severe cases, careful monitoring of the patient’s condition must be undertaken to ensure that there is no delayed hypersensitivity reaction, and if anaphylaxis occurs, medical attention will be promptly provided.|
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