A client receives an IV penicillin infusion and reports itchiness with hives on the back and neck. What is the nurse's immediate action?

• A. Discontinue IV and continue normal saline then report to Dr.
• B. Stop the IV but continue the penicillin infusion as planned.
• C. Remove the IV and apply a warm compress.
• D. Call the family and wait for orders.

Answer: (A)

When a patient receiving IV penicillin reports itchiness with hives, the priority is to stop exposing the body to the offending drug. Discontinuing the IV infusion prevents further administration of penicillin and potential progression of the allergic reaction. Keeping the IV line open with normal saline allows continued IV access for fluids and any medications the physician orders to treat the reaction. After stopping the drug, promptly notify the prescriber so they can decide on the appropriate treatment (such as antihistamines, steroids, or epinephrine if needed) and monitor the patient closely. If signs of a more severe reaction develop (airway swelling, trouble breathing, or hypotension), be prepared to initiate emergency procedures immediately.