Patient Care and Monitoring

1. Before administering any medication, take a thorough drug history to establish any past allergic or adverse reactions experienced by the patient.

2. For any reaction, use questions given in Table 54-5 to establish the nature of the reaction and the likelihood it was caused by the suspected drug. For nonantibiot-ics, the first question regarding infection type is not needed.

3. Document the reaction, in detail, in the patient's medical record.

4. Recommend an alternative choice if the prescribed drug is contraindicated, and develop a plan to assess safety and effectiveness.

5. Consult with a physician trained in desensitization if the patient has a true allergy and no acceptable alternative medication is available.

6. Educate the patient about the allergy or pseudoallergy so they are able to work with health care providers to avoid the reaction in the future.

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