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A patient comes in saying "I think I have a allergy to peanuts" what is the nurses best response? A. What reaction did you have when eating the peanuts?
B. What makes you think you are allergic to peanuts?
C. Do you have other allergies besides peanuts?
D. What time did these problems arise?
I said B. The teacher said I was reading too much into it and because we are on nutrition chapter I should have known the answer was A.
Well, they're kind of saying the same thing, BUT...
A. What reaction did you have when eating the peanuts?
The nurse takes the pt's report as a given, and then asks for more information. You'll see a lot not so much with peanuts, but with medications--take morphine for example. Pt says 'I'm allergic to morphine." Many people say that when they've had an adverse reaction like nausea; this is different from a true allergy which could cause a hypersensitivity reaction, up to and including anaphylaxis.
B. What makes you think you are allergic to peanuts?
This wording conveys an adversarial response that could make the pt shut down. Pt reports a piece of his medical history, and the nurse says "What makes you think...?" kind of implies that she might not put a lot of stock in it.
C. Do you have other allergies besides peanuts?
This is appropriate to ask after documenting the peanut information.
D. What time did these problems arise
Irrelevant. The pt is not reporting present sx. If pt rings call bell and reports hives and difficulty breathing, this question would be part of that assessment.
Yea That's a good rationale but here's another question. An 81 year old postop patient is being admitted to an assisted care facility. The patient states "I will never be able to go home" what is the most therapeutic response? A. A lot of older patients get admitted to assistive care. B. what makes you think you will be there permanently? C. Assistive care can be very beneficial for your age group. D. I'm willing to bet that you actually enjoy and appreciate this facility once you get there.
Here I would choose B. This is a different situation. In the previous question, you need to know specific information so you know how to treat the patient. With this question, the patient is expressing fear. They would be most assisted here by being listened to and feeling like someone hears them and cares.
When a patient tells you about an allergy, you should always ask the patient what happens when they are exposed to said allergen. That is common practice in nursing. You ask this question because you'll find that a lot of people, especially with medications, don't know the difference between an allergy and a side effect. Also, you need to know if it's a severe allergy. If peanuts make them a little itchy that's one thing, but if they say their throat closes up you need to make sure you get an order for an epi pen and keep it near by.
And for the the second question, the answer is the "why" response. You want to facilitate open communication with your patients. The other answers might sound like you'd be comforting your patients, but they can also be misinterpreted as diminishing the patient's feelings. With these types of questions, you always want to pick the answer that is the most likely to start a conversation. Don't think about what sounds the nicest or what you would most like to hear. The people that make these questions want to see that you will be able to communicate with your patients in a way that will get them talking about their fears and concerns, not just that you are able to comfort them.
JustBeachyNurse, LPN
13,957 Posts
Penicillin is an antibiotic (high frequency of allergy). Epinephrine and. Benadryl are used for allergies. Neither need to be fired up