A nurse is assisting with the care of a client who is receiving penicillin via intermittent IV bolus. Which of the following should the nurse recognize as a clinical manifestation of anaphylaxis?

Choice A: This is incorrect because pallor is not a sign of anaphylaxis. Pallor can indicate shock, anemia, or hypoxia.

Choice B: This is incorrect because peripheral edema is not a sign of anaphylaxis. Peripheral edema can indicate heart failure, kidney disease, or venous insufficiency.

Choice C: This is incorrect because hypertension is not a sign of anaphylaxis. Hypertension can indicate stress, pain, or renal disease.

Choice D: This is correct because pruritus is a sign of anaphylaxis. Pruritus is a severe itching sensation that can accompany hives, rash, or angioedema.

Choice A reason: Eliminating egg whites from the diet is not necessary, as they are a good source of protein and do not contain any fat or cholesterol. The client should limit or avoid egg yolks, which are high in cholesterol and saturated fat.

Choice B reason: Using coconut oil when preparing food is not advisable, as it is a source of saturated fat that can raise blood cholesterol levels and increase the risk of atherosclerosis and heart disease. The client should use unsaturated fats, such as olive oil or canola oil, which can lower blood cholesterol levels and improve heart health.

Choice C reason: Eating fish three times a week is a good practice, as fish are rich in omega-3 fatty acids that can reduce inflammation, lower blood pressure, and prevent blood clots that can cause heart attacks or strokes. The client should choose oily fish, such as salmon, tuna, or mackerel, which have higher amounts of omega-3 fatty acids.

Choice D reason: Including 2 percent milk in the diet is not recommended, as it contains more fat and calories than skim or 1 percent milk. The client should choose low-fat or fat-free dairy products, such as yogurt, cheese, or milk, which can provide calcium and protein without excess fat.