A nurse is assessing a client for risk factors of anaphylaxis. Which of the following factors should the nurse consider?

Rationale: Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that can cause a dry, persistent cough as a common adverse reaction. The cough is due to the accumulation of bradykinin, which is a vasodilator and an inflammatory mediator that is normally degraded by ACE. The cough usually resolves after discontinuing the medication.

B) is incorrect because metformin is an antidiabetic agent that does not cause a cough as an adverse reaction. The most common adverse reactions of metformin are gastrointestinal disturbances, such as nausea, vomiting, diarrhea, and abdominal pain.

C) is incorrect because atenolol is a beta blocker that does not cause a cough as an adverse reaction. The most common adverse reactions of atenolol are bradycardia, hypotension, fatigue, and dizziness.

D) is incorrect because glipizide is a sulfonylurea that does not cause a cough as an adverse reaction. The most common adverse reactions of glipizide are hypoglycemia, weight gain, and skin rash.

Amoxicillin is a penicillin derivative that has a high cross-reactivity with penicillin. Therefore, the nurse should hold the medication and notify the provider of the client's allergy. The provider may prescribe an alternative antibiotic that belongs to a different class, such as a macrolide or a fluoroquinolone.

A) is incorrect because administering the medication as prescribed and monitoring for signs of an allergic reaction can put the client at risk of developing a serious or life-threatening reaction, such as anaphylaxis. The nurse should not administer any medication that the client is allergic to.

C) is incorrect because asking the client about the type and severity of his allergic reaction to penicillin is not enough to prevent an allergic reaction to amoxicillin. Even if the client had a mild reaction to penicillin in the past, he may have a severe reaction to amoxicillin in the present. The nurse should avoid giving any medication that has cross-sensitivity with penicillin.

D) is incorrect because administering an antihistamine before giving the medication to prevent an allergic reaction is not a safe or effective practice. Antihistamines do not prevent anaphylaxis, which is a life-threatening reaction that requires immediate intervention. Antihistamines can also mask some signs of an allergic reaction, such as itching and hives, making it harder to detect and treat.