A client receives a subcutaneous omalizumab injection in the clinic for severe allergic asthma. Which post-administration practice most reflects the FDA boxed warning?

• 1 Discharge the client within 5 minutes after injection, instructing them to self-monitor for signs of anaphylaxis at home and to call 911 if symptoms develop; no in-clinic observation or emergency supplies required.
• 2 Arrange for a home health nurse to administer omalizumab at the client's home, instruct the client to remain for 30 minutes after injection and to call 911 if any signs of anaphylaxis develop; no emergency supplies needed.
• 3 Pre-medicate with oral diphenhydramine 50 mg 30 minutes before injection, then observe for 15 minutes and discharge with instructions to monitor for delayed symptoms; no emergency supplies or extended observation necessary.
• 4 Observe in the clinic for at least 2 hours after the first several doses (and at least 30 minutes thereafter), with anaphylaxis emergency supplies immediately available; counsel about delayed reactions up to 24 hours ✓ Correct answer

For study reference only. Always follow current clinical guidelines and your institution’s protocols.