You are NOT allergic to...

[BuckyBadgerRN]

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.

OK, rant over

[BuckyBadgerRN, ASN, RN]

I worked in dentistry for MANY years before going to nursing school, I can assure you that no DDS I have ever known has told someone that, but I'm sure they do exist!!

What I've discovered with the epi "allergy" is the fault of a dentist. Pt goes to the dentist, gets some lido with epi, and has a reaction. Dentist tells pt "you're allergic to epi and can never have it again" so pt believes that. When I tried to explain that the allergy is most likely to the lidocaine and epi is adrenaline that your body produces, I got argued with and told that I was flat wrong because Dr. Dentist said no epi. Did I mention I was an allergy nurse and we rx epipen/adrenaclick/auvi-q daily? Yeah, we know a thing or two about epi.

Flu shot--allergy to eggs. FYI, it has been proven safe for an egg-allergy pt to receive the flu shot, and only if you've reacted to the flu vaccine itself should you proceed with caution.

Morphine--makes me itch

Prednisone--tachycardia, sleeplessness, increased appetite

I try to clarify the difference between allergy and s/e

My favorite--asking parent if child has any allergies, parent says allergy to PCN, I ask what reaction pt has, parent says they don't know but parent is allergic to it so they keep the child away from it too. So, pt has never had a reaction to it? No.

[BuckyBadgerRN, ASN, RN]

You'll be a hero when you "cure" a patient receiving narc pain medications with a PRN docusate =)

I'm still in nursing school but during clinical one of my patients had an allergy to Norco because it made them constipated...

[nt28]

The other day I had a patient allergic to water.

[BuckyBadgerRN, ASN, RN]

TRULY allergic or does it just upset their stomach?

The other day I had a patient allergic to water.

[Anna Flaxis, BSN, RN]

The other day I had a patient allergic to water.

But what I really want to know is, did you enter it into the EHR?

[QuiltDog]

I remember years ago when I was working in Day Surgery, we got this woman who had so many stated allergies it took three allergy bands.

I have this corollary that states that the greater the number of stated allergies, the greater the probability that the patient has a mental health history.

I agree with your corollary 100%!!!! I feel the same way and have seen it many times

[edmia, BSN, RN]

Okay, so what are people's thoughts on amoxicillin rashes?

When my youngest was 2, he received amoxicillin and on day 7 or 8, he broke out into an itchy swollen rash over his entire body. In my reading, that seems to be a not-uncommon reaction and not a true allergy. But his physician at the time said "Let's just be safe and put it as an allergy; there are plenty of other antibiotics out there to use." But I don't want to tell him all his life that he has an allergy to cillins if he doesn't.

A true drug rash is not pruritic or has hives. It is a morbilliform rash and is not a real allergy in the way we are looking at it. It won't progress to anaphylaxis.

The hives and itching point to an IgE mediated response and is an allergy.

Sent from my iPhone -- blame all errors on spellchecker 😉

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[Here.I.Stand, BSN, RN]

Okay, so what are people's thoughts on amoxicillin rashes?

When my youngest was 2, he received amoxicillin and on day 7 or 8, he broke out into an itchy swollen rash over his entire body. In my reading, that seems to be a not-uncommon reaction and not a true allergy. But his physician at the time said "Let's just be safe and put it as an allergy; there are plenty of other antibiotics out there to use." But I don't want to tell him all his life that he has an allergy to cillins if he doesn't.

Klone, I was just thinking of this example as one of "maybe not a true allergy, but shouldn't take it." My 13 yr old daughter broke out in a diffuse rash after a couple of doses of amoxicillin when she was 6. I'd started listing it as an allergy (somehow I'd forgotten about that from pharm class...honestly I had no idea), and at a well-check her ped told me "it was probably just an amoxicillin rash. It's not uncommon."

But the thing of it is, a few of those lesions were blistered. I am very concerned that in light of the blisters, down the road it could be SJS/TEN. So I told her ped my concerns, and said it needs to stay listed as an allergy. He was very agreeable. I have also told her what SJS/TEN are, and that she needs to be aware that that is why I always list it as an allergy. Just in case a provider down the line tells her it was just a side effect. Why risk a devastating, life-threatening side effect when there are other antibiotics available?

[SleeepyRN]

It's not the patient's lack of understanding that is irritating. It's the fact that a NURSE (or someone with the authority to take a medical history) enters these things into the legal document that is a medical record. Did you read the initial rant?

I'm with you up until what it is that actually bothers you. You're annoyed at the medical professional while I give a good eye roll (in my head) to the patient. I may very well know that a patient isn't actually allergic to something. But if after briefly educating the patient doesn't help and the patient still claims to have an allergy, you bet I'm covering my butt by entering what the patient says. I thought this post was going to be fun. But as previously stated, if you let something that small get under your skin, well....Sucks to be you, I guess.

[CelticGoddess, BSN, RN]

My favorite was potassium. The person in question insisted that she was allergic to K+. One of her meds listed was K-phos. She told me that that was different. It was potassium, it was K. I asked her what happens when she takes it, she told me that it makes her arm hurt. She pointed to the IV site. She currently had NS with 20KCl running. Her arm wasn't hurting this time though.

An of course all the people who are allergic to morphine (It make me sleepy, nauseated, flushed, etc) but they aren't allergic to the "d" one.

[iluvivt, BSN, RN]

Thank you Katie MI, How did you know all that,wow! I too cannot have shellfish,orange dye or soda or use any products with iodine. I also cannot drink red wine but I think that may be a different process not sure though. I start itching especially my face and scalp and then get a rash that oddly starts at the ACF and works it way down my arms!

[CelticGoddess, BSN, RN]

The other day I had a patient allergic to water.

There actually is documented proof of people having a reaction to water. It's rare but it happens.

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