RESIDENT_____________________________________

DATE

PROBLEM

GOAL

TO DATE

INTERVENTIONS

RESP

DISC

Food Allergies

Food intolerance

Lactose intolerance

At risk for injury and discomfort related to food allergies

Resident is allergic to:

Resident will be free of allergic reaction

Make sure resident’s allergies are well documented throughout the chart, medication records, menu cards, dietary records, and all other pertinent documents

Consult with Dietician to make sure foods served to resident are free of allergens

Offer food alternatives to replace foods resident is allergic to

Observe for signs and symptoms of allergic reaction

Make sure that all necessary staff members are alerted to resident’s allergies

Assess resident’s knowledge and understanding of avoiding allergens

Instruct resident and family in avoiding allergens