The practical nurse (PN) is discharging a client who had an anaphylactic reaction following administration of ampicillin. Which instruction is most important for the PN to provide this client?

Choice A reason: Gum appearance is unrelated to carbamazepine’s side effects or sore throat. While some antiseizure drugs cause gingival hyperplasia, carbamazepine does not, and gum assessment does not clarify the sore throat’s cause, which may indicate infection or agranulocytosis, making this choice irrelevant.

Choice B reason: Bowel sounds assess gastrointestinal function, not relevant to a sore throat or carbamazepine’s effects. Sore throat may signal agranulocytosis, a rare side effect, but bowel sounds do not provide data on infection or hematologic issues, making this choice inappropriate.

Choice C reason: Carotid pulse volume evaluates cardiovascular status but is unrelated to sore throat or carbamazepine’s side effects. Sore throat may indicate infection or agranulocytosis, requiring systemic assessment like temperature, not vascular checks, making this choice irrelevant for the reported symptom.

Choice D reason: Temperature is critical, as sore throat may indicate infection or agranulocytosis, a rare but serious carbamazepine side effect causing low white blood cells. Fever suggests infection, necessitating urgent reporting. This assessment provides key data to differentiate causes, guiding timely intervention.

Choice A reason: Asking the spouse why the client is outside is irrelevant to the clinical concern. Fluoroquinolones cause photosensitivity, increasing sunburn risk. The focus should be on protecting the client from UV exposure, not investigating their location, making this choice unhelpful for addressing the drug’s side effect.

Choice B reason: Notifying the supervisor about an improved condition is premature and unrelated to the client being outdoors. Sitting outside does not indicate recovery, and the priority is addressing photosensitivity from fluoroquinolones, which risks skin damage, making this choice incorrect.

Choice C reason: Fluoroquinolones, like ciprofloxacin, increase photosensitivity by sensitizing skin to UV light, causing severe sunburn or rash. Reminding the client to use sunblock and protective clothing prevents dermal damage during sunlight exposure, directly addressing the drug’s side effect and ensuring safety.

Choice D reason: Encouraging staying indoors is overly restrictive and impractical. Photosensitivity can be managed with sunblock and clothing, allowing safe outdoor activity. This choice unnecessarily limits the client’s mobility, as proper precautions effectively mitigate the risk of UV-related skin damage.