A nurse is assessing a client who has a prescription for cefaclor. Which of the following findings should the nurse recognize as an indication of an allergic reaction?

A) Ask another nurse to check the medication dosage prior to administration: While double-checking medication dosages with another nurse can be a part of the medication safety process, it primarily ensures the right dose rather than confirming the right medication. This action focuses on the right dose rather than the right medication.

B) Use two client identifiers prior to administering the medication: This action aligns with the principles of medication safety and the "five rights" of medication administration, which include the right patient. Using at least two client identifiers, such as name and date of birth, helps ensure that the medication is being administered to the correct patient, which is essential for preventing errors related to patient misidentification.

C) Document the full name of the prescribed medication after administration: While accurate documentation is important for maintaining a complete record of medication administration, documenting the full name of the medication after administration does not directly ensure that the right medication was administered beforehand. It is a step in the documentation process but does not specifically address the verification of the medication before administration.

D) Verify a written order with the medication administration record: Verifying a written order with the medication administration record helps ensure that the correct medication is being administered as prescribed by the healthcare provider. However, this action focuses on confirming the accuracy of the prescription rather than confirming the right medication immediately before administration.

A) Give diphenhydramine IM: Diphenhydramine is an antihistamine that can help alleviate allergic symptoms such as itching, hives, and mild allergic reactions. However, in the case of an anaphylactic reaction, which is a severe and potentially life-threatening allergic reaction, diphenhydramine alone may not be sufficient. While it can be administered as an adjunctive therapy, it is not the primary intervention for anaphylaxis. Therefore, giving diphenhydramine IM should not be the next action after stopping the medication infusion.

B) Elevate the client's legs and feet: Elevating the client's legs and feet is a supportive measure that can help improve venous return to the heart and mitigate symptoms of hypotension. However, in the context of an anaphylactic reaction, the priority is to address airway compromise and cardiovascular collapse, as these are life-threatening complications. Elevating the legs and feet may be considered after administering epinephrine and ensuring stabilization of the client's airway, breathing, and circulation.

C) Replace the infusion with 0.9% sodium chloride: While stopping the infusion of the offending medication is essential in managing an anaphylactic reaction, replacing it with 0.9% sodium chloride solution alone does not address the systemic effects of anaphylaxis. The priority is to administer medications such as epinephrine to reverse the allergic response and stabilize the client's condition. Therefore, replacing the infusion with 0.9% sodium chloride should not be the next action after stopping the medication infusion.

D) Administer epinephrine IM: Epinephrine is the first-line treatment for anaphylaxis due to its rapid onset of action and ability to reverse bronchoconstriction, vasodilation, and increased vascular permeability associated with the allergic reaction. Administering epinephrine IM helps counteract the severe manifestations of anaphylaxis, including respiratory distress and hypotension. Therefore, it is the most appropriate next action after stopping the medication infusion and assessing the client's respiratory status.