# Minutes after an IV antibiotic begins, a client develops wheezing, facial swelling, generalized hives, and blood pressure of 74/40 mm Hg. Complete the emergency response. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=568918&lang=en > language: en > subject: Medical Emergencies > category: PA ## Question Minutes after an IV antibiotic begins, a client develops wheezing, facial swelling, generalized hives, and blood pressure of 74/40 mm Hg. Complete the emergency response. The nurse should recognize ::선택::a mild isolated rashexpected antibiotic intolerancestable seasonal allergyanaphylaxis with shock, immediately ::선택::stop the antibiotic and give IM epinephrine promptly under the emergency protocolwait for symptoms to resolve without interventiongive only an oral antihistamineask the client to walk to the clinic, and then ::선택::delay oxygen until formal criteria are documentedleave the client to obtain a routine historyactivate emergency support, provide airway and oxygen support, give prescribed isotonic fluid, and reassess for repeat epinephrineoffer oral fluid despite airway swelling and shock. ## Explanation Wheezing, angioedema, hives, and hypotension minutes after an antibiotic indicate anaphylaxis. Stop the trigger and give IM epinephrine promptly under the emergency protocol, while activating help, supporting airway and oxygenation, giving isotonic fluid as prescribed, and reassessing for repeat epinephrine. ## In-depth explanation Quick answer Recognize anaphylaxis, stop the antibiotic and give prompt IM epinephrine under the emergency protocol, then support airway, oxygenation, and circulation while reassessing for additional epinephrine. Why this is correct Rapid wheezing, facial swelling, diffuse hives, and shock after a likely trigger involve multiple organ systems and show life-threatening anaphylaxis. Epinephrine is first-line and should not be delayed for formal diagnostic criteria or antihistamines. Easy analogy or mental picture The airway is tightening while blood vessels suddenly lose tone and leak fluid; epinephrine counters both processes at once. Memory hook Airway plus low pressure after a trigger: IM epinephrine first. NCLEX decision rule Remove the trigger when possible, but never let that delay epinephrine. Activate emergency support, provide high-flow oxygen, prepare airway assistance and isotonic fluid, monitor continuously, and repeat epinephrine according to protocol if symptoms persist. Why the other choices are wrong Antihistamines do not rapidly reverse shock or airway obstruction. Observation, oral fluids, or waiting for a provider callback delays the first-line lifesaving treatment. Source 12023 Anaphylaxis Practice Parameter Update 2Resuscitation Council UK Anaphylaxis Guidance 32026 NCLEX-RN Test Plan ## Clinical scenario The nurse stops the suspected trigger, remains with the client, and activates the emergency response. Epinephrine, oxygen, airway equipment, and isotonic IV fluid are immediately available under the facility's emergency protocol. ## Key concepts - **Anaphylaxis** — A rapid, systemic hypersensitivity reaction that can compromise the airway, breathing, or circulation. - **Intramuscular epinephrine** — First-line anaphylaxis treatment injected into muscle to rapidly support airway, breathing, and circulation. - **Angioedema** — Rapid swelling of deeper skin or mucosal tissues that can involve the face, lips, tongue, and airway. ## Related questions - [A nurse is caring for an alert adult client with type 1 diabetes who reports tremors, swea…](https://mymerci.kr/pages/nclex_q.php?qn_id=360524&lang=en) - [A 58-year-old client arrives at the emergency department with crushing substernal chest pa…](https://mymerci.kr/pages/nclex_q.php?qn_id=362976&lang=en) - [A 72-year-old client is brought to the emergency department by family who report that the …](https://mymerci.kr/pages/nclex_q.php?qn_id=363003&lang=en) - [A 79-year-old client is admitted from a long-term care facility with diarrhea, decreased o…](https://mymerci.kr/pages/nclex_q.php?qn_id=363089&lang=en) - [A 68-year-old client is admitted to the emergency department with suspected sepsis from a …](https://mymerci.kr/pages/nclex_q.php?qn_id=363987&lang=en) - [A nurse is caring for an adult client in the emergency department who is suspected to have…](https://mymerci.kr/pages/nclex_q.php?qn_id=363993&lang=en) - [A nurse is teaching a 72-year-old client with chronic heart failure (reduced ejection frac…](https://mymerci.kr/pages/nclex_q.php?qn_id=366202&lang=en) - [A nurse is caring for an adult client admitted with diabetic ketoacidosis. 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