A nurse is caring for a client who is receiving parenteral nutrition and identifies that the client has hypoglycemia. Which of the following actions should the nurse take?

A) "This medication will not interfere with the effectiveness of oral contraceptives": Rifampin is known to induce hepatic enzymes, which can accelerate the metabolism of oral contraceptives and reduce their effectiveness. Therefore, it is essential for clients taking rifampin to use alternative or additional contraceptive methods to prevent pregnancy.

B) "You can continue to wear soft contact lenses while taking this medication": Rifampin can cause discoloration of bodily fluids, including tears, which may stain soft contact lenses. Therefore, clients taking rifampin should be advised to avoid wearing soft contact lenses during treatment to prevent discoloration and potential eye irritation.

C) "You should take this medication once each day at bedtime": Rifampin is usually taken once daily, but the specific timing may vary depending on the indication and healthcare provider's instructions. While taking rifampin at bedtime may be suitable for some clients, it is important to follow the prescribed dosing schedule provided by the healthcare provider.

D) "Your urine will turn orange while you are taking this medication": Rifampin can cause harmless discoloration of urine, tears, saliva, sweat, and other bodily fluids, turning them orange-red. This side effect is temporary and not harmful. However, informing the client about this potential effect is essential to prevent alarm or unnecessary concern.

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.