A nurse is preparing an educational training session about collaborating with the provider to prevent medication errors. Which of the following information should the nurse include in the teaching?

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.

A) Grasp skin between thumb and forefinger throughout the injection: This is the correct answer. Grasping the skin between the thumb and forefinger creates tension, which helps to stabilize the tissue during the injection. This technique reduces the risk of tissue damage and minimizes bleeding following the injection of heparin subcutaneously.

B) Aspirate the syringe prior to injecting the heparin: Aspiration is not necessary for subcutaneous injections, as the risk of intravascular injection is minimal. Aspirating the syringe can increase discomfort for the client and is not recommended for subcutaneous injections.

C) Use the Z-track method to administer the medication: The Z-track method is used for intramuscular injections to minimize medication leakage into the subcutaneous tissue. However, heparin is typically administered subcutaneously, and the Z-track method is not appropriate for this route of administration.

D) Gently massage the site following the injection: Massaging the site following a subcutaneous injection of heparin can increase the risk of bleeding and hematoma formation. Therefore, this action should be avoided to minimize bleeding at the injection site.