Canceled Patient Morphine Allergy

Nurses Safety

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Hello everyone,

I am a new to practice RN. Yesterday I had a pt. come in with severe abdominal pain. The doctor was at the bedside and ordered morphine. When I asked the pt. if she had any drug allergies she stated that she didn't have any allergies. She was given morphine 4 mg, then 8 mg. After being given the second dose of morphine, the pt. states that she is allergic to morphine and Ativan. I asked her what happens when she gets morphine and she states that it makes her nauseous. She was given Zofran and I did pt. teaching on the difference between side effects and allergy. Pt. asked if I can take that allergy out of the system so I canceled the allergy on the request of the pt. Thinking in hindsight, I feel like I should not have canceled it. I feel like I should have just documented her symptoms. I want to go back to the hospital and rechart the allergy with the symptoms, but I am so nervous about doing so. Was it the right thing to cancel the allergy? Should I go back and change it in her chart?

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She's not allergic to morphine, you gave her 12mg. You're fine..

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Thanks MilliePieRN!

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Specializes in PICU, Sedation/Radiology, PACU.

One of my biggest pet peeves is documented allergies” that are actually expected side effects. When clinicians try to order these medications it triggers a hard stop in the computer system. Then pharmacy has to call the ordering doc to clarify. It creates delays, extra work, and sometimes ends up with the patients not receiving the medications that would be most effective for them.

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Specializes in LTC and Pediatrics.

There are some eMars out there that only have "allergy" I wish they had a section for those meds some of us can't tolerate. I have one med that I am not allergic too, but is causes hypotension and bradycardia so I can't take it. A section like this would help in this case as you could put the med there with the side affect and how to use it for this patient.

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Specializes in Medical-Surgical/Float Pool/Stepdown.
There are some eMars out there that only have "allergy" I wish they had a section for those meds some of us can't tolerate. I have one med that I am not allergic too, but is causes hypotension and bradycardia so I can't take it. A section like this would help in this case as you could put the med there with the side affect and how to use it for this patient.

I think hypotension and bradycardia are on a bit of a different level than mild nausea or say drowsiness...:lol2:

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Specializes in PICU, Sedation/Radiology, PACU.
I think hypotension and bradycardia are on a bit of a different level than mild nausea or say drowsiness...:lol2:

Or an allergy to fentanyl because it causes "itching."

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Specializes in LTC and Pediatrics.

My point is that there should be a place to mark such meds, with the reaction that occurred. That way it can be determined whether that med can be used with help for the side affects.

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Specializes in Medical-Surgical/Float Pool/Stepdown.
My point is that there should be a place to mark such meds, with the reaction that occurred. That way it can be determined whether that med can be used with help for the side affects.

I do get the point, just saying I wouldn't be the least bit annoyed if I had a patient tell me they couldn't have a drug because it causes those symptoms as opposed to "I get sick to my stomach with pain pills"...well, here's a cracker then and let's try it.

My EMR lets me put the med (or whatever) along with the reaction and also lets me select a severity level I consider for the type of reaction. It also allows a free text area for those random things like say vision loss, turns fingers blue, or whatever the patient describes.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I think hypotension and bradycardia are on a bit of a different level than mild nausea or say drowsiness...:lol2:

Me too. I always say I'm allergic to lisinopril. I'm not allergic -- I just have an idiosyncratic reaction to it. It puts me into right sided heart failure. So even though I'm not really allergic, I don't want to get the stuff.

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Specializes in LTC and Pediatrics.

I am glad to hear that the eMars are starting to do this. Where I have been, this isn't the case yet.

I do get the point, just saying I wouldn't be the least bit annoyed if I had a patient tell me they couldn't have a drug because it causes those symptoms as opposed to "I get sick to my stomach with pain pills"...well, here's a cracker then and let's try it.

My EMR lets me put the med (or whatever) along with the reaction and also lets me select a severity level I consider for the type of reaction. It also allows a free text area for those random things like say vision loss, turns fingers blue, or whatever the patient describes.

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Specializes in School Nursing, Hospice,Med-Surg.

I think it was correct to cancel the Morphine allergy as it wasn't a true allergy.

I always have caregivers document Ultram as an allergy for myself even though it's not a "true" allergy...but it does aggravate seizures for me so I very much appreciate it when no one gives it to me! Seizures are a possible side effect and an extremely unpleasant one at that.

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