A nurse is collecting data from a client following the administration of a new medication. Which of the following findings should the nurse identify as a manifestation of an allergic reaction?

A. "Limit potassium-containing foods in your diet." Long-term prednisone use can lead to hypokalemia (low potassium levels) due to its mineralocorticoid effects, which increase potassium excretion. Clients on chronic corticosteroid therapy may actually need to consume potassium-rich foods to help maintain electrolyte balance, rather than restricting them.

B. "Withhold prednisone for 48 hours prior to receiving contrast dye." There is no general recommendation to withhold prednisone before contrast dye administration. However, clients on long-term steroid therapy may require stress-dose steroids if undergoing procedures that could trigger an adrenal crisis. Withholding prednisone without provider guidance could increase the risk of adrenal insufficiency.

C. "Measure your blood glucose levels periodically." Prednisone can cause hyperglycemia by increasing insulin resistance and promoting gluconeogenesis. Clients, especially those with diabetes or at risk for metabolic syndrome, should monitor blood glucose levels regularly to detect potential steroid-induced diabetes. Adjustments in diet or medication may be needed based on blood glucose trends.

D. "Take prednisone on an empty stomach." Taking prednisone on an empty stomach can increase the risk of gastrointestinal irritation, ulcers, and gastritis. It should be taken with food or milk to help reduce stomach irritation and minimize gastrointestinal side effects. Clients should be advised to follow this guideline to prevent discomfort and potential complications.

A. Aspirate before injecting the medication. Aspirating before injecting heparin is not recommended because it can cause tissue trauma and increase the risk of hematoma formation. Heparin is administered into the subcutaneous tissue, which has fewer blood vessels than intramuscular tissue, making aspiration unnecessary. Aspiration can also lead to bruising and discomfort, which should be minimized when administering anticoagulants.

B. Use a 25-gauge, 1/2-inch needle to administer the medication. Heparin should be administered using a small-gauge (25- to 27-gauge) needle with a length of 1/2 to 5/8 inch to reduce tissue trauma and minimize the risk of bleeding. The small needle size helps ensure that the medication is delivered into the subcutaneous tissue rather than deeper layers. Proper needle selection is important to prevent bruising and irritation, which are common concerns when administering anticoagulants.

C. Administer the medication within 2 cm (1 in) of the umbilicus. Heparin should not be injected near the umbilicus because this area has a higher density of blood vessels and an increased risk of bruising. The preferred injection sites are the abdomen (at least 5 cm or 2 inches away from the umbilicus), the upper outer thigh, or the outer upper arm. Injecting in these areas ensures proper absorption while minimizing complications such as hematoma formation.

D. Massage the site after injecting the medication. Massaging the injection site after administering heparin is contraindicated because it can lead to increased bruising, tissue irritation, and the potential for excessive bleeding. Instead of massaging, gentle pressure can be applied with a gauze pad if necessary to control minor bleeding. Clients should be advised to avoid rubbing or applying unnecessary pressure to the injection site to reduce the risk of local complications.