A client receives a prescription for golimumab for psoriasis. Which information should the practical nurse (PN) obtain prior to administration?

Choice A reason: Restlessness, tachycardia, fever, and hypertension suggest serotonin syndrome, a life-threatening paroxetine side effect due to excessive serotonin. Withholding the dose and contacting the provider prevents further serotonin accumulation, allowing urgent assessment and intervention to stabilize the client’s neurological and cardiovascular status.

Choice B reason: A cooling blanket addresses fever but is not the first action for serotonin syndrome. Withholding paroxetine and consulting the provider are critical to stop the syndrome’s progression, as fever is a symptom, not the cause, making this choice secondary to halting the drug.

Choice C reason: Taking the client to a quiet area may reduce stimulation but does not address serotonin syndrome’s physiological cause. Paroxetine’s serotonin excess drives symptoms, requiring drug cessation and medical intervention, not just reassurance, as this condition can rapidly worsen, making this choice inadequate.

Choice D reason: Administering benzodiazepine and acetaminophen is premature without provider guidance, as serotonin syndrome requires specific treatments, like cyproheptadine. Paroxetine must be stopped first, and the provider consulted to confirm diagnosis and manage symptoms, making this choice unsafe and reactive.

Choice A reason: Diphenhydramine does not facilitate rapid transfusion. It is an antihistamine used to prevent allergic reactions during transfusions, not to alter infusion speed. Rapid infusion depends on clinical protocols and patient tolerance, not antihistamine effects, making this choice incorrect.

Choice B reason: Diphenhydramine does not inhibit antigen-antibody reactions, which occur in transfusion mismatches. It mitigates histamine-mediated allergic symptoms, like itching or hives, but does not prevent immunological reactions. This choice is incorrect, as it misrepresents the drug’s role in symptom management.

Choice C reason: While diphenhydramine may cause sedation, its primary purpose before transfusion is to prevent allergic reactions, not to promote relaxation. Relaxation is a secondary effect, not the clinical rationale for its use, making this choice less accurate than allergy prevention.

Choice D reason: Diphenhydramine, an antihistamine, minimizes allergic reaction symptoms, such as itching or hives, during blood transfusions by blocking histamine receptors. This premedication reduces the risk of mild transfusion-related allergic responses, ensuring patient comfort and safety, making it the correct explanation.