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A patient who had arteriosclerotic cardiovascular disease complained to his nurse that he had severe chest pain, unrelieved by nitroglycerin. The nurse notified his doctor, who gave a verbal order for morphine to be given immediately. She quickly prepared and gave the dose. A few minutes later, the nurse transcribed the morphine order to the patient's medication administration record. She glanced at the allergies listed for this patient and was shocked to see morphine as the first allergy on the list.
The nurse rushed to check the patient and call the doctor. Fortunately, the patient suffered no ill effects from the morphine.
You may think that if the patient had been wearing an allergy alert bracelet or had an allergy alert sticker placed over his bed, this error wouldn't have occurred. But these devices can't replace deliberate, reasoned thought. Also, don't rely on stickers placed above the bed since patients are often moved without their stickers. Before you administer any drug, you must ask yourself: Is there any reason why the patient shouldn't receive this drug? By asking this question, you can consider not only the patient's allergies, but also his condition, which may contraindicate the drug's administration. Then you can check for allergy alerts.
So make it a habit. When you check the "five rights" of drug administration (the right patient, drug, dose, time, and route), consider also whether the patient can safely take the drug in the . first place. Remember: Bracelets and stickers can't prevent medication errors ... but a thinking, vigilant nurse can.