A nurse administered a dose of penicillin to a client 30 min ago.The client reports she has hives and is itching.
Which of the following statements by the nurse is the highest priority?

Choice A rationale

Performing neurovascular checks every 2 hours ensures that the nurse can quickly identify signs of compromised circulation or nerve function in the affected extremity. This includes monitoring for changes in color, temperature, sensation, and movement, which are critical for preventing complications such as compartment syndrome.

Choice B rationale

Positioning the fractured arm below the level of the client's heart can increase swelling and impair circulation to the area. It is generally recommended to elevate the arm to reduce edema and promote better blood flow.

Choice C rationale

Immobilizing the client's fingers using a hand splint is not necessary unless there are additional injuries to the hand or fingers. The focus should be on the distal radius fracture and maintaining mobility in the fingers to prevent stiffness and promote circulation.

Choice D rationale

Using a hair dryer to blow hot air into the cast can cause skin burns and damage the cast material. Itching under the cast should be managed with safe methods such as blowing cool air or taking antihistamines if necessary.

Choice A rationale

Having clear liquids up to 3 hours before the procedure is incorrect. Clients are generally advised to be NPO (nothing by mouth) for a certain period before a bronchoscopy to prevent aspiration.

Choice B rationale

Eating as soon as the procedure is completed is incorrect. Clients need to wait until their gag reflex has returned before eating or drinking to prevent choking or aspiration.

Choice C rationale

Blood-tinged sputum after the procedure is an expected finding. Bronchoscopy can cause minor irritation and bleeding in the airways, leading to blood-tinged sputum.

Choice D rationale

Receiving an injection of radioactive material prior to the procedure is incorrect. This statement confuses bronchoscopy with other diagnostic tests such as a PET scan. Bronchoscopy involves direct visualization of the airways using a bronchoscope. .