A nurse observes client receiving fat emulsions is having hives. A nurse reviews client’s history and notes which of following may be caused by complaint of client?

Correct Answer: A. Allergy to an egg.

Fat emulsions (lipids) contain egg yolk phospholipids and should not be given to clients with egg allergies. Intravenous fat emulsions (IFEs) are a vital component of total parenteral nutrition, because they provide essential fatty acids. IFE is a sterile fat emulsion that contains egg-yolk phospholipids. Although egg allergy is listed as a contraindication, adverse reactions are uncommon.

• Option B: Hypersensitivity reactions to TPN can be managed by withholding the TPN and treating with antihistamines if needed until the reaction resolves. Identification, possibly by epicutaneous allergy testing, and removal of the offending agent(s) from the TPN is necessary if TPN therapy must be restarted.
• Option C: Although ingestion of egg lecithin in cooked food is generally tolerated by egg-allergic people, administration of intravenous egg-containing lipid emulsions may cause significant adverse reactions.
• Option D: If the patient has an allergy to amino acids, dextrose, fat emulsion, or any other part of total parenteral nutrition, he should be referred to a doctor first. If the patient has an allergy to corn, corn products, eggs, peanuts, or soybeans, he should talk with a doctor.