A client develops wheezing, generalized hives, and blood pressure 78/42 mm Hg after receiving an antibiotic. Which medication should the nurse prepare to administer first?

1 Intramuscular epinephrine ✓ Correct answer
2 Inhaled corticosteroid
3 Oral diphenhydramine
4 Oral acetaminophen

Explanation

Wheezing, hives, and hypotension after antibiotic exposure indicate anaphylaxis. Intramuscular epinephrine is the first-line medication because it supports airway, breathing, and circulation. Antihistamines or corticosteroids may be adjuncts but do not replace epinephrine for life-threatening anaphylaxis.

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In-depth explanation

Clinical Judgment
Recognize multi-system allergic reaction with hypotension as anaphylaxis and treat ABCs first.

Memory Tip
Anaphylaxis equals epinephrine first.

KR vs US
NCLEX distinguishes adjunct allergy medications from first-line emergency epinephrine.

Clinical scenario

Clinical Practice Guide
Anaphylaxis with respiratory compromise or hypotension requires immediate epinephrine and emergency support.

Caution
Do not delay epinephrine while waiting to see whether symptoms improve.

Key concepts

Anaphylaxis — A severe systemic allergic reaction that may cause airway swelling, bronchospasm, hypotension, and shock.
Epinephrine — First-line medication for anaphylaxis that improves airway tone, bronchodilation, and blood pressure.
Hypotension — Low blood pressure that can indicate shock and inadequate organ perfusion.

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

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A client develops wheezing, generalized hives, and blood pressure 78/42 mm Hg after receiving an antibiotic. Which medication should the nurse prepare to administer first?

In-depth explanation

Clinical scenario

Key concepts

Master the NCLEX-RN with MyMerci