# A client receiving IV vancomycin develops flushing of the face and neck and itching during the infusion. Which action should the nurse take?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=394082&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client receiving IV vancomycin develops flushing of the face and neck and itching during the infusion. Which action should the nurse take?

## Option

1. Stop or slow the infusion according to policy and notify the provider. **✔ Correct answer**
2. Increase the infusion rate to complete the dose faster.
3. Document the reaction as expected and continue at the same rate.
4. Give the next dose by IV push.

**Correct answer: 1**

## Explanation

Flushing and itching during vancomycin infusion may indicate an infusion-related reaction. The nurse should stop or slow the infusion according to policy, assess the client, and notify the provider. Rapid infusion can worsen the reaction.

## In-depth explanation

Clinical Judgment
Medication reactions require stopping the source and assessing the client.

Memory Tip
Vancomycin flushing: slow or stop, then report.

## Clinical scenario

Clinical Practice Guide
Vancomycin should be infused at an appropriate rate and clients should be monitored for infusion reactions and allergy symptoms.

Caution
Do not confuse an infusion reaction with a reason to push the medication faster.

## Key concepts

- **Vancomycin** — An antibiotic used for selected serious gram-positive infections.
- **Infusion Reaction** — A reaction related to the rate or process of IV medication administration.
- **Pruritus** — Itching that can occur with allergic or infusion-related reactions.

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