SUPPLEMENTAL MATERIAL CHAPTER 4 QUESTION
1. A friend mentions they have suddenly discovered they are allergic to peanuts . They became constipated after the last time they ate them. Is this reaction a food allergy or an intolerance?
ANSWER
Symptoms of a food allergy are more likely to occur within minutes of ingestion, and include symptoms like hives, itchy mouth, coughing, or diarrhea. If severe, a food allergy can cause shortness of breath, passing out, or anaphylaxis. Experiencing constipation after eating peanuts is most likely a food intolerance.
9
2. An employee was cutting tuna sandwiches and turkey sandwiches with the same knife, on the same surface . What should the employee be doing differently to prevent food allergen cross-contact?
3. List three ways to avoid cross contact when preparing food.
One type of sandwich (turkey) should be prepared and cut first, then the surface scrubbed and sanitized. Then, the next batch of sandwiches (tuna) prepared and cut with a clean knife. It may be necessary to use separate equipment to complete both of these tasks to prevent cross-contact.
1) Use Separate Utensils and Equipment: Always use different knives, cutting boards, and other utensils for allergen- containing and allergen-free foods.
2) Clean Thoroughly: Wash all utensils, equipment, and surfaces with hot, soapy water after they come into contact with allergens.
3) Hand Hygiene: Wash hands thoroughly and change gloves after handling allergen-containing foods before touching allergen-free foods.
4) Separate Storage: Store allergen-containing foods separately from allergen-free foods to avoid accidental contact
4. What modifications or replacements should be made to the following menu items to omit the 9 major food allergens?
• Peanut butter & jelly sandwich on whole wheat bread • Asian shrimp stir-fry with slivered almonds • Chocolate cake • Tuna salad with mayonnaise and boiled eggs
5. A tray is being loaded into a delivery cart to take to a client with a peanut allergy. The tray was recently sitting on a table where a batch of peanut butter cookies was cooling. What should happen next?
6. A client mentions he is choosing to use apple cider vinegar to manage his diabetes instead of taking his diabetes medications. Who should be notified of this information?
7. A client’s family member brought him over-the-counter ginkgo biloba supplements after the client had mentioned he was having difficulty remembering things. What further information would be important to determine safety? Who should the CDM, CFPP report this information to?
The peanut butter can be replaced by sunflower seed butter in the peanut butter & jelly sandwich. The stir-fry could be made with chicken instead of shrimp, and the slivered almonds left off. The chocolate cake (milk, eggs) could be replaced with another dessert free of the top 9 allergens, or a milk & egg-free recipe used; the tuna salad could be replaced with a chicken or bean salad.
First stop the tray from going to the patient; then notify a foodservice supervisor and/or registered dietitian nutritionist of the incident. The patient should be given a new food tray to eliminate the possibility of peanut contamination from the peanut butter cookies having affected the original tray.
A registered dietitian nutritionist should be notified in order to discuss the existing research surrounding apple cider vinegar, and to discuss evidence-based medical nutrition therapy for diabetes.
It would be important to know if the patient has been taking gingko biloba, how much he is taking, and what other medications he is prescribed. The information should be reported to the client’s registered dietitian nutritionist and physician.
Nutrition Fundamentals and Medical Nutrition Therapy
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84
