The patient comes to the emergency department with a severe allergic reaction to peanuts and is in serious respiratory distress. The patient's spouse tells the nurse that the patient has a known hypersensitivity to epinephrine (Adrenalin). What is the best response by the nurse?
1. "I will let the physician know about this immediately; we will need to choose an alternative medication."
2. "I'm not sure what we can use then. Do you know what has been used before with this allergic response?"
3. "This is a life-threatening situation; a prior hypersensitivity is not an absolute contraindication."
4. "This is a problem; we will need to use IV diphenhydramine (Benadryl)."
3
Rationale 1: Speaking with the physician to choose an alternative drug is not indicated.
Rationale 2: The nurse must speak with conviction to decrease anxiety in the patient and spouse.
Rationale 3: Although epinephrine is contraindicated for known hypersensitivity to the drug, in life-threatening situations there are no absolute contraindications to its use.
Rationale 4: Diphenhydramine (Benadryl) may not be the best choice.
Global Rationale: Although epinephrine is contraindicated for known hypersensitivity to the drug, in life-threatening situations there are no absolute contraindications to its use. Diphenhydramine (Benadryl) may not be the best choice, and the nurse must speak with conviction to decrease anxiety in the patient and spouse.
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