So we are switching to a new computer system at work. Not everything will carry over and we have to do some manual entry of certain things. Allergies is one of the items that falls onto that list. We are able to print out that info from the old system so we can put in onto the new, so the information has all been verified at some point by nursing staff or physicians. Which also means at one point it was all ENTERED by someone with a license or someone who is supposed to have enough medical knowledge to do such things.
Some of the "allergies" (complete with reaction, since it's a required field):
Nitroglycerin---"it makes my ears ring"
Tetnaus shot---"my arm hurts after I get one"
E-mycin---"diarrhea"
iron supplements---"makes my BM dark"
and my favorite:
Epinephrine---"makes my heart race"
Seriously?! I can shrug and say "meh" to many things, but truly?! WHY do trained professionals DO this? Go ahead and put some of these things down and attribute the poops after an ABX to a side effect, but not an ALLERGY. Yes, side effects, intolerances and allergies are all options to choose from.
I am not even entering the epinephrine "allergies", nope, not doing it.
True story: Little old man told me he was allergic to Lasix. "How unusual - never had anyone allergic to that before" says I.
Little old man, "Yeah, when I take that pill all I do is pee!" When I explained that it was the desired effect, he got agitated and responded, "Why in the WORLD would anyone make a pill like that?"
Lasix allergy is actually not all that uncommon, since there is some cross reactivity with that and sulfa, and sulfa allergies are pretty common. We used to never give lasix to our sulfa allergic patients- always bumex. The cross reactivity rate must be pretty low, though, because we stopped that and I have yet to see a lasix reaction. My own father is sulfa allergic and on a hefty lasix dose daily for forever.
Insulin allergy in patients with diabetes mellitus on insulin treatment is a rare condition. It is suspected upon noticing immediate symptoms following insulin injections
......
Yes, people can be allergic to a naturally occurring substance in their body
Adverse effects that aren't allergies can be serious too.
I have Aspirin sensitive asthma, and can't have any aspirin or NSAID products, as they tend to send me into life threatening asthma attacks. Not an allergy- but I list it as such.
We don't give GCSF to patients with monosomy 7 because it can stimulate their cancer to grow/return. They get it listed as as allergy too.
Insulin allergy in patients with diabetes mellitus on insulin treatment is a rare condition. It is suspected upon noticing immediate symptoms following insulin injections
......
Yes, people can be allergic to a naturally occurring substance in their body
If you read the article, the four cause studies they present, three of them were resolved by switching to a different type of insulin and adding antihistamines (in addition to immunotherapy). The third was switched to pills. The article says that allergies were less common with human preparations and preparations without zinc, again suggesting it's not the insulin that's the allergy- it's something in the preparation. Another patient mentioned in the article couldn't tolerate any formulation of subq insulin, but could tolerate it IV, diluted to 500u/100ml, so they put a CVL in and gave her a pump to have an insulin drip all the time. If it was truly the insulin that was the problem, I would think delivering it directly into the veins would make it far worse.
I never understood some of the "allergies" I always inform my patients they have a right to refuse any and all medical care. If Vicodin makes you constipated, refuse the meds & tell your doctor to give you something else. Never understood how its so hard to simply speak up.
Specializes in Med-Surg, OB, ICU, Public Health Nursing.
Prior to anaphylactic reaction to contrast, I found out I was "allergic" to benadryl. I was given it IV in the ED and developed urticaria at the site. So, I wear medic alert tag. Terrified I might be in crash/crush injury and they would order contrast and treat anaphylacsis with benadryl. MD believed it might be the preservative in the benadryl, but advised against taking it again.
No words. Well, actually I do have words. Start hiring real nurses (LPN/RN) instead of MAs for doctor's offices. Yes, the doctors will have to pay them more, but the likelihood of this boneheaded move happening is much less.
I work PRN for an Allergist. Before hiring me, they were going to hire an MA. This bone head doctor I work for has no idea what the vast difference is between MAs and nurses. He only hired me because he knows my mom, and he got me for cheap. When I'm giving allergy shots, I shake my head sometimes thinking about that. Every single interaction I have with a patient before and after each injection comes with NURSING assessment. I also provide a lot of pt. education. Sure, doc. Try and hire an MA for this, then see what happens.
blondy2061h, MSN, RN
1 Article; 4,094 Posts
Lasix allergy is actually not all that uncommon, since there is some cross reactivity with that and sulfa, and sulfa allergies are pretty common. We used to never give lasix to our sulfa allergic patients- always bumex. The cross reactivity rate must be pretty low, though, because we stopped that and I have yet to see a lasix reaction. My own father is sulfa allergic and on a hefty lasix dose daily for forever.