Food Allergy Basics

What are food allergies?

Food allergies involve the immune system and occur in people who overreact to foods that are generally regarded as harmless. Allergic reactions to foods occur when the body’s immune system identifies a food protein or allergen as a ‘foreign body,’ and in response it activates defense systems to try to stop or eliminate the allergen, thus causing the symptoms of allergic reactions. Food allergy can be mild or severe. It can be transient or last a lifetime. 

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What foods commonly cause allergic reactions?

Children are commonly allergic to two or three foods, sometimes more. The most common ones are peanuts and tree nuts, cow’s milk and eggs. Less common triggers are seafood, sesame, wheat and soy. Wheat and soy allergies tend to be mild and transient. Fortunately most children grow out of egg, milk, wheat and soy allergies before they reach school age, however peanut, tree nuts (most commonly cashew nuts), seeds and seafood allergies may persist in adulthood.

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The term tree nut is often used to mean specific nuts (Walnut, Brazil, Cashew, Hazelnut, Macadamia , Pine, Pecan, Pistachio and Almond).

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How will my body react if I have a food allergy?

Allergic reactions can vary between individuals and can affect different systems of the body. In its mild and chronic form, eczema is the most common presenting symptom of food allergy. In its severe form reactions can occur immediately or within an hour or two of even the smallest amount of the offending allergen and result in itching, rash, hives, breathing difficulties, swelling of the mouth and throat or asthmatic attack and potentially circulatory collapse (anaphylaxis). When a severe reaction happens, the body will respond by producing its own adrenaline and recovery will occur, but under certain circumstances not enough adrenaline is produced, and the reaction may be fatal. Therefore, for those at risk of having anaphylaxis, management includes having an adrenaline auto-injector (EpiPen®) to have on hand at all times in the event of accidental exposure. 

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Food allergy symptoms can be immediate and may include:

• Itchiness
• Rash
• Hives
• Swelling
• Runny nose
• Breathing difficulties
• Nausea
• Stomach pains
• Diarrhea
• Vomiting

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People who have had an EpiPen® prescribed need to be aware of it’s correct usage, the expiry date and need to make sure that it is not exposed to high temperatures, so don’t leave it in the car! People needing an EpiPen® can join the EpiClub ( www.epiclub.com ) which sends you a reminder of when your EpiPen® expires and other management tips.

Who is most likely to develop food allergies?

There is a genetic predisposition to becoming allergic. People with food allergy usually have a family history of allergic disorders such as asthma, eczema and hay fever. If a family has one child with food allergy, the brothers and sisters of that child have a greater risk of developing food allergy.

While food allergy tends to present in infants and very young children, asthma and hay fever tend to present as they get older. Those currently considering finding information on how to become a nutritionist will find there is quite a bit of exposure to allergy treatment during internship.

How is food allergy identified?

A detailed clinical history will be taken by the doctor, and then either skin prick tests (SPT) or blood tests (radioallergosorbent test RAST) need to taken to confirm the presence of IgE antibodies in order for a diagnosis of allergy.

Food allergies should always be investigated by the appropriate medical professional i.e. GP/Immunologist and dietary adjustments should always be made under the supervision of a Registered Dietitian (RD) or Accredited Nutritionist (AN) who specializes in food allergy.

How do we treat food allergy?

After identifying the food trigger/s it is important to avoid the allergen/s to prevent further reactions. Levels of avoidance will vary depending on the severity of reaction, the age of the child, the type of food involved, and the family’s social situation. If total avoidance is advised this may include avoiding products that are labeled ‘may contain traces of the allergen.’ Sometimes reactions are so severe, for example in the case of peanut allergy, that airborne particles can be enough to trigger a reaction.

Unfortunately for the general public, advice from nutritional experts can be confusing, especially when it comes to whether or not we can prevent allergy, and how strictly they need to avoid the allergen if they are already allergic. At the moment more research is needed with respect to prevention of food allergy. Some dietetic professionals advise that food avoidance will not prevent allergy, and others advise that avoidance of nuts and seafood by direct and indirect contact, and not binging on any foods (especially eggs and dairy), can lessen the likelihood of sensitization.

Your GP/Immunologist will help you devise an Action Plan in the event of exposure to the allergen/s, especially where anaphylaxis is concerned. Recognizing the early symptoms of an allergic reaction and knowing what to do if it happens can help people with food allergy learn to live with their condition.

This article has briefly addressed some of the issues in the complex and controversial area of food allergy. If you suspect food allergy, consultation with your GP and/or Immunologist is recommended.

References:

1. Calvi, K, Investigating Food Intolerance
2. Australian Society of Clinical Immunology & Allergy, Food Allergy, ASCIA Education Resources, Patient Information;http://www.allergy.org.au/images/stories/aer/infobulletins/pdf/aer_food_allergy_april2009.pdf
3. Dept. Allergy & Immunology, Children’s Hospital Westmead, Factsheet, Allergy – tree nuts, http://www.sch.edu.au/health/factsheets/joint/?tree_nut_allergy.htm
4. Thomas, B, Manual of Dietetic Practice, Blackwell Publishing, 2002.
5. Sampson HA. Food Allergy. Part 2: Diagnosis and Management. Journal Allergy Clinical Immunology 1999; 103 (6): 981-95.
6. Wardlaw, G. M., Perspectives in Nutrition, McGraw-Hill, Boston, 1996
7. Royal Prince Alfred Hospital, Friendly Food, Murdoch Books, 1997
8. Tang MLK, Robinson M 2008, Allergy prevention. Current recommendations and new insights. Australian Family Physician 37(4): 204-208.
9. Prescott SL, Smith P, Tang M, Palmer DJ, Sinn J, Huntley SJ, Cormack B, Heine RG, Gibson RA, Makrides M 2008, The importance of early complementary feeding in the development of oral tolerance: concerns and controversies. Pediatric Allergy Immunology 19: 375-380

Nephrology Nursing

“Nephrology” is the field of medicine that focuses on the diagnosis and treatment of kidney disease; therefore, a nephrology nurse is a nurse whose specialty is working with patients who have various disorders of the kidneys.

 Beginning in the early 1970s, the federal government recognized end stage renal disease (or ESRD) as a disease-caused disability. As such, federal funding for treatment of this disease by dialysis or by kidney transplant became much more readily available, and nephrology nursing began to evolve. 

Today’s nephrology nurses help not only chronically ill ESRD patients, but also work to prevent kidney disease with those who are at risk, and work with all the body’s organs to keep patients healthy. They tend to also be educated in the fields of gerontology, cardiovascular disease, diabetes, anemia, and bone care management, because patients with kidney diseases tend to suffer from other problems, as well.

 Roles of Nephrology Nurses 

 Because kidney disease takes many different forms, the sub-specialties of nephrology nurses are likewise broad in range. Some nurses specialize in dialysis, some with transplants or recovering donated organs. There are nephrology nurses who work only with adults, while others work only with children. There are nephrology nurses in private doctor’s offices, but there are also nephrology nurses in hospitals and outpatient clinics. Here’s a closer look at some of the sub-specialties of these nurses.
 

The Different Roles of Nephrology Nurses 

 Dialysis Nurses 

 Dialysis is the process whereby the body’s fluids are cleansed artificially through special equipment. The kidney’s normal function in the body is to remove waste products and excess fluids from the body. People whose kidneys are not functioning properly require regular dialysis treatments – usually three to four days per week. Dialysis nurses are specially trained nurses who operate the dialysis machine for these patients. Before and after treatment, they perform a patient assessment, which is critical in understanding how well a patient is responding to the dialysis. These nurses are often responsible for maintaining the dialysis equipment through general maintenance.

 Pediatric Nephrology Nurses 

 Pediatric nephrology nurses specialize in working with children who are experiencing kidney disease or kidney failure. This nurse works not only with the patient, but also helps educate the patient’s family about how to help the child lead the most normal, comfortable life possible. And because their patients are children, the pediatric nephrology nurses also offer a great deal of psychological support, both for the child and his/her family. Because the child with kidney disease requires a good deal of specialized treatment, the nurse often works to help coordinate the child’s care with other hospital departments, such as urology, radiation, nutrition, psychiatry, and anesthesia. 

Transplant Nurses 

 Kidney transplants are the most common type of organ transplant performed. Nurses who work with transplant patients coordinate their care before, during, and after the transplant operation. They educate the patient and their family, and help the patient have a smooth transition back into normal life. The rewards of this sub-specialty of nephrology nursing are obvious – for a successful transplant patient, the medical team is giving the patient a second chance at life, because without a transplant, patients often do not survive.

 Not all transplant nurses work with the recipient of the donated kidney; some transplant nurses focus on the care of the donor him or herself, as the donor is prepared for the surgery, undergoes the kidney removal, and recovers afterward.

 Becoming a Nephrology Nurse 

 Once an RN decides to specialize in nephrology, they can become a Certified Nephrology Nurse (CNN), but they can also certify to specialize in dialysis as a Certified Dialysis Nurse (CDN). While most states require that nurses operating dialysis equipment be certified, not all nephrology nurses are required to be certified. Many organizations state that they prefer to hire CNN nurses, but it is not a requirement to work in the field of nephrology.

 Job Prospects for Nephrology Nurses 

 Unfortunately, because the risk factors for kidney disease, such as obesity and diabetes, are on the rise, the number of Americans with kidney disease is also steadily rising. Currently, it is estimated that between 10 and 20 million Americans have kidney disease, and Stage 5 chronic kidney disease, or CKD, is growing at a rate of approximately 3% per year. As such, the number of nurses required to care for these patients is also growing. Nephrology nursing is a rapidly expanding field. RN jobs in Bakersfield Ca have increased dramatically over the last decade: there are currently 5 outpatient dialysis clinics in the city, as well as Acute programs at 7 Kern County hospitals.

 RNs who specialize in renal dialysis earn an average salary of $73,000 per year. Hourly rates for these nurses vary widely depending upon the state of employment and the job function of the nurse, ranging anywhere from about $32 per hour for inexperienced nurses to $60+ per hour for experienced dialysis nurses working through nursing agencies. Because dialysis nursing involves complex equipment and a good deal of specialized knowledge, on the whole they earn more than other clinical nurses. Ancillary staff positions are also increasing. Because of the complexities of dialysis patients' diets, Registered Dietitians are also in demand. "How to become a nutritionist" or "How to become a dietitian" are common search terms.....In the State of California, dietary healthcare employment is typically contingent on the prospective employee being registered through the appropriate licensing body. In the case of dietitians, that is the Commission on Dietetic Registration.(CDR), which is the credentialing agency for the Academy of Nutrition & Dietetics.

Community Health Nurse

Overall job prospects for both registered and licensed practical nurses are excellent compared to other occupations. Community Health nurses, in particular, are in especially high demand as there is a critical shortage of nurses practicing this particular specialty.

What is Community Health Nursing?

Community Health Nursing, interchangeably referred to as Public Health Nursing, combines nursing with public health principles. It involves actively promoting the health of a specific population or community utilizing expertise from nursing, social science, and public health. Instead of attending to the health of an individual or a family, the community health nurse targets improving the health of a community as a whole. Disease and injury prevention are a central focus of this field of nursing specialization.

What Do Community Health Nurses Do?

Community Health Nurses make health care readily available to populations with limited access to basic preventative services. They focus closely on the prevention of disease, injury, disability, and premature death. Community health nurses often work in tandem with other public health professionals such as health educators, epidemiologists, nutritionists, and public health physicians. They work within specific communities to determine the major health problems of that population and devise plans to alleviate those problems.

Community health nurses perform a diverse array of job functions which may include:

• Coordination with local housing authorities to ensure adequate affordable housing.
• Working with day care providers to verify adherence to national child care standards.
• Identification of neighborhoods with low immunization rates and implementation of a plan to increase those rates.
• Assisting young mothers in accessing health care services for themselves and their children.
• Providing post-disaster medical care in an emergency shelter.
• Educating groups about the threat and prevention of pandemic illnesses such as influenza.
• Interviewing individuals diagnosed with communicable conditions to determine the likely source of the illness.

The Different Roles of Community Care Nurses

The role of the community health nurse varies, but usually falls into one of three categories:

Occupational Health Nurse
Occupational Health Nurses provide medical care and assistance to workers at a job site.

General Practice Health Nurse
General Practice Health Nurses usually work out of local government health departments which may include home visits and clinic work.

Case Management Nurse
Case Management Nurses have a designated caseload of families or individuals that they assist with specific health related concerns such as communicable diseases.

Practice Settings

Public Health nurses work in a variety of settings outside of the traditional hospital. These may include schools, homes, clinics, jails, work sites, health departments, and mobile vans.

Community Health Nurse Job Requirements

Entry Level Educational Requirements

A Bachelor of Science in Nursing (BSN) degree is usually the minimum educational requirement for a career as a community health nurse. However, there are some opportunities for licensed practical nurses (LPNs) with an Associates degree. Currently, there are no Community Health job openings on the LVN Jobs In Bakersfield Ca. board. Only about 5% of entry level nurses take jobs in the public sector. This accounts for the shortage of nurses in this field, and the intense demand for qualified nursing candidates in this specialty.

Advanced Level Educational Requirements

Those wishing to advance to decision making level positions in Community Health nursing find that a higher level of education is usually required. Community health nurses in management level positions typically hold a Master of Science in Nursing (MSN) Degree, or are a Clinical Nurse Specialist with a concentration in Community and Public Health. The Clinical Nurse Specialist in Public/Community Health Nursing is a common professional credential held by nurses in this field.

General Qualifications

Community Health nurses require skill in disease prevention, health promotion, case management and strategic planning. They must be able to adapt to practicing nursing in non-traditional medical environments. Community health nurses must possess the skills to effectively communicate and interact with individuals from culturally diverse backgrounds.

Nursing Salary & Compensation

Registered nurses earned an annual median income of $67,280 in 2014. The middle 50% of nurses in 2014 earned salaries ranging from $57,710 to $79, 850. Nurses in the highest 10% of earners made in excess of $93,440. The breakdown of median incomes among industries employing the largest numbers of registered nurses in 2014 were as follows:

Employment services $64,260
General medical and surgical hospitals $68,550
Home health care services $64,190
Offices of physicians $63,800
Nursing care facilities $62,490

Community Health nursing is, without question, a challenging field of specialization. The challenge, however, is not without reward. Community Health nursing has positively impacted public health in communities across the country in areas such as: injury prevention, asthma control, child abuse and neglect prevention, and family functioning. For the nurse desiring to utilize her/his skills in an under-staffed specialty with excellent opportunity for long term career growth, Community Health nursing may be the ideal choice. Those searching for RN Jobs In Bakersfield Ca will find an abundance of Community Health positions.

Cardiac Care Nurse

Nurses interested in cardiac medicine may consider specializing in cardiac care nursing. There is a shortage of nurses in general, but the shortage is particularly acute in nursing specialties such as cardiac care. The American Heart Association reports that in 2004 nearly 80 million Americans were living with some form of cardiovascular disease. Roughly 1.5 million patients enter cardiac care units each year due to heart attacks. In light of the significant percentage of the population afflicted with cardiac related illnesses, the need for skilled cardiac care nurses is particularly dire.

WHAT IS A CARDIAC CARE NURSE?

Cardiac care nurses work with patients and the family members of patients who have contracted heart disease. They are often specialized nurses who work as part of a critical care nursing unit. Cardiac care nurses work mostly with patients at high risk of likely or actual life threatening medical problems. They draw upon their specialized education, skill, and experience to provide essential care to these patients. Routine duties of cardiac care nurses may include:

• Response to cardiac emergencies
• Functioning as a liaison with patient families
• Ongoing monitoring of cardiac patients
• Development of individualized care plans
• Administering medications
• Providing relevant education to patients and families

Work Setting and Job Opportunities

The majority of cardiac care nurses work in hospitals. They usually staff a critical care or cardiac care unit, but may also work in intensive care units, cardiac catheter labs, telemetry units, progressive care units, emergency departments, or recovery rooms.

• Cardiac care centers are usually found in large regional health care facilities. Because cardiac care is so extensive, many smaller hospitals do not offer cardiac care outside of emergency treatment.
• Though hospitals are the most common work environment for cardiac care nurses, they do work in settings outside of the hospital. Common non-hospital settings include:
• Cardiac Rehabilitation Facilities
Nurses work in these facilities as part of the patient care management team. They assist patients learning to live with cardiovascular disease by educating them and their families on medicine, medical procedures, and lifestyle modifications. They also supervise or assist with physician prescribed exercise programs.
• Nursing Homes and Long-Term Care Facilities
In these type facilities, nurses work as part of the patient care model. They make regularly scheduled visits to patients, make recommendations on diet and exercise, monitor their medications, and suggest lifestyle modifications as needed.
• Visiting Nurse Programs
Patients living with cardiovascular disease may require ongoing support and guidance from a cardiac care nurse. Nurses who work in one of these programs make routine visits to patients in their homes to monitor their health and check on their progress.

JOB REQUIREMENTS

Educational Requirements Cardiac care nurses typically hold a Bachelor of Science in Nursing (BSN) degree. There are, however, those who have two-year degrees with a combination of registered nurse (RN) licensure, on the job training, and direct experience in critical or cardiac care units. Nursing schools offer exposure to critical care, but the specialty education received by cardiac care nurses is usually provided by the employer. Certification Certification is not a mandatory requirement, but many employers prefer to hire certified nurses for this type of care. Certification is popular because it demonstrates a distinct level of knowledge and expertise that has been verified by a valid job related exam. To maintain certification, nurses must undergo a renewal process every three years which requires specific continuing education and clinical experience requirements. Nurses must have been in practice for a minimum of two years before being eligible to take an exam. Advanced Practice Nurses wishing to pursue advanced practice in cardiac care can pursue a critical care nurse specialist certification (CCNS). The American Association of Critical Care Nursing (AACN) is one certifying body that administers these types of certification exams which are required for licensure in advanced practice. There are two common certifications pursued by nurses wishing to purse advanced practice in cardiac care. Cardiac Medicine Certification is a sub-specialty designed for nurses who provide care for critically ill cardiac patients. Cardiac Surgery Certification is for nurses who provide advanced care to patients in the 48 hours immediately following cardiac surgery.

Nursing Salary & Compensation

According to the Bureau of Labor statistics, median earnings for registered nurses, by industry, in 2013 were as follows: Employment services $64,260 General medical and surgical hospitals 58,550 Home health care services 54,190 Offices of physicians 53,800 Nursing care facilities 52,490 Heart disease is one of the main causes of death in the United States, resulting in a in a high demand for cardiac care nurses. Recent technological and pharmaceutical advancements have further contributed to the need for qualified nurses to fill positions in this field. Nurses willing to gain the requisite education to practice in this specialty can look forward to a prosperous long term career.

OB/GYN Nursing In Bakersfield

Gynecology/obstetric nurses are nurses who specialize in the field of women’s reproductive health. A broad nursing field, gynecology/obstetric nursing (also referred to as OB/GYN nursing) covers a broad range of aiding women with reproductive health, from teaching women about contraception techniques, caring for and educating expectant mothers, and working with mothers and their newborns. The field is further divided into the two main sub-fields of perinatal nursing and labor and delivery nursing. The Bakersfield College nursing program currently has their L&D rotation 3rd semester.

Perinatal Nursing
These nurses work with women before, during, and after childbirth. In addition to their roles caring for pregnant women, these nurses act as educators for expectant mothers: perinatal nurses teach mothers about different delivery techniques, they stay with and support the mother during the actual childbirth, and after childbirth they continue to support mother and newborn by teaching the mother how to bond with her new baby, including teaching the mother about nursing her newborn. Perinatal nurses play an important role in the mother’s psychological health, not just her physiological health. Because of the emphasis on helping mother and baby bond, perinatal nursing is also sometimes called Mother/Baby/Couplet Care Nursing.

Labor & Delivery Nursing
While nurses in the perinatal field may be found in clinics, Kern County hospitals, and private offices around the country, labor and delivery nurses tend to be found primarily in hospital settings. Sometimes called L&D nursing, labor and delivery nurses provide care to women during the process of birth and the period of time just following birth. Nursing programs in Bakersfield Ca typically include an L&D rotation. The primary job of a labor and delivery nurse is to assess each mother and newborn and create an individualized plan of care for them. Before birth, some of their jobs include tracking fetal heart rates and identifying ahead of time which mothers may face postpartum depression. They check the lab work of their patients, ask for additional tests if they feel necessary, and work with a mother’s attending physician to ensure the birth and post-birth process go smoothly for her and her newborn.

Further Roles of Hospital L&D Nurses
Labor and delivery nurses can be further sub-divided based on the different kinds of roles they play.

• Antepartum nurses: These nurses work with expectant mothers who are considered to have high-risk pregnancies.
• Circulating nurses: This labor and delivery nurse works primarily in the operating room, where he or she cares for patients during caesarean section deliveries.
• Scrub nurses: Like the circulating nurse, this labor and delivery nurse is also found in the operating room, but he or she works directly with the surgeon who is performing the c-section through passing the surgical instruments.
• Postpartum nurses: Postpartum nurses work with mother and child directly after birth.
• Nursery nurse: These nurses work in the nursery, providing care for newborns.

Becoming an OB/GYN Nurse
OB/GYN nurses are registered nurses (RNs) who work in the field of obstetrics/gynecology. To start with, there is no special education or certification required to work as an OB/GYN nurse – an RN license is sufficient to get started in this field. However, once working in an OB/GYN field, it’s not a bad idea to gain certification in one’s sub-specialty, to show commitment to the field and earn a higher rate of pay. Some hospitals state in their OB/GYN job openings that they prefer RNs who hold bachelor’s degrees in nursing. However, not all OB/GYN nurses hold BSN degrees. All hospitals are different; some hospitals will hire new RNs into certain OB/GYN departments, such as postpartum and nursery, but not in other departments.

Job Prospects for OB/GYN Nurses In Bakersfield
Probably the hardest part about becoming an OB/GYN nurse is finding a job. While there is a nationwide shortage of nurses, OB/GYN nursing is a popular field that many nurses love working in. Therefore, in comparison to some other nursing fields, job turnover is relatively low, making openings more scarce than in other nursing fields. Be sure to check our RN board for up-to-date nursing jobs in Bakersfield Ca. OB/GYNs are not the highest paid nurses in the field. In California, pay varies quite a bit by County and by hospital, but average salaries for OB/GYN nurses, even those with multiple years of experience, is generally between $32 and $39 per hour in Kern County. The average salary for an OB/GYN nurse practitioner (higher level of education than a regular RN) is $84,000, compared to an average starting salary for all nurse practitioners of $76,000. Overall, OB/GYN nursing is a very rewarding field, as nurses work with future mothers, new mothers, and their infants to ensure the creation of healthy, happy families.

How to Become a CNA In Bakersfield Ca

CNA training & certification in California is often one of the first steps taken when considering a career in the healthcare field. Aside from the classes & clinical hours needed to complete a CNA program(currently 100 hours in the State of California), there are a variety of technical steps you must take in order to become a CNA. Once you do become a Certified Nursing Assistant, the competency level you'll be held to will be dictated by the California Department of Public Health, not your employer. Going beyond your scope of responsibility not only leaves your patients at risk, it leaves you at risk as well.

Step 1: Get a High School Diploma In order to become a CNA, you must obtain a high school diploma or GED. Nowadays, you cannot become a certified nursing assistant in California without a one of these.

Step 2: Volunteer at a Hospital Many CNA candidates start their career by volunteering at a local Kern County hospital. This allows you to understand how the health care system works and what your job will entail. You will also become familiar with many the requirements of the facility you work in. Volunteer work is a great step towards finding CNA jobs in Bakersfield Ca.

Step 3: Get CNA Training There are several different ways you can get trained to become a CNA in Kern County. You can enroll in one of the many CNA classes in Bakersfield Ca at technical schools and community colleges that offer the program. Many Southern California schools offer programs that allow you to obtain certification at the end. According to current California guidelines, all CNA candidates must complete a minimum of 60 hours of coursework and 100 hours of clinical practice. California has its own training requirements that you must be familiar with. During CNA training, you will learn the basics of nutrition, communication skills, resident rights, infection control, and how to provide care for patients. It is important to make sure that the program you are enrolling in is approved by California. There are many fly-by-night operations that aren't licensed by the California Department of Public Health to offer CNA training.

Step 4: Take the Exam and Get Certified Once you complete the CNA training program in Bakersfield, you must pass the CNA exam in order to get certification. You must provide documentation of the completed training and learn about California’s requirements for obtaining certification. The exam is administered by the State. There are sample tests available online to help you prepare for it.

Step 5: Write a Resume and Ace the Interview Once you pass the test, you can congratulate yourself on becoming a Certified Nursing Assistant. The next step is to write your resume and prepare for job interviews. Consider highlighting your experiences including volunteer work, training and certification. When going in for an interview, show what you have accomplished during your training and experiences and sell your talent for caring for others. This will help you ace the interview and start working in a local Kern County facility.