A nurse is preparing to administer medications to a client. At which of the following times should the nurse compare the medication administration record and the medication label? (Select all that apply.)

A. Corneas with an opaque appearance:

An opaque appearance of the corneas indicates an abnormal finding and could suggest a pathological condition such as corneal edema, scarring, or infection. The corneas should normally be clear and transparent to allow light to pass through to the retina.

B. Pupils that are 8 to 9 mm in diameter:

Pupils that are 8 to 9 mm in diameter are abnormally large and dilated. Normal pupil size varies between approximately 2 to 4 mm in diameter under normal lighting conditions. An 8 to 9 mm diameter suggests mydriasis, which may be caused by various factors such as medications, neurological conditions, or trauma.

C. Eyelashes that curl slightly outward.

Eyelashes that curl slightly outward are a normal finding and help to protect the eyes by preventing foreign particles from entering. This finding is considered within the range of normal anatomy and physiology of the eye.

D. Eyelids that blink involuntarily 30 to 35 times per minute:

While blinking is a normal physiological response that helps to keep the surface of the eye moist and clear debris, the rate of involuntary blinking typically ranges from 15 to 20 times per minute in adults, not 30 to 35 times per minute. A higher rate of blinking could indicate irritation, dryness, or other ocular discomfort.

A. A feeling of swelling in the feet: Swelling in the feet can be caused by various factors such as fluid retention, circulatory issues, or certain medical conditions like venous insufficiency. It is not a typical symptom of anaphylaxis, which usually involves more generalized symptoms such as hives, itching, swelling of the face or throat, difficulty breathing, and a drop in blood pressure.

B. Pain at the injection site: Pain at the injection site is a common side effect of receiving an injection or medication. It occurs due to tissue irritation or trauma from the needle. While allergic reactions can cause localized redness, swelling, or itching at the injection site, severe pain alone is not a hallmark symptom of anaphylaxis.

C. A sudden decrease in heart rate: Anaphylaxis typically leads to an increase in heart rate (tachycardia) rather than a decrease. This increase in heart rate is a response to the body's attempt to compensate for the drop in blood pressure caused by anaphylaxis. Bradycardia (a decrease in heart rate) is not a typical feature of anaphylaxis unless it occurs very late in a severe reaction due to profound circulatory collapse.

D. A sharp decrease in blood pressure: This choice is indicative of an understanding of possible anaphylaxis. Anaphylaxis can cause a rapid and severe drop in blood pressure, known as hypotension. This drop in blood pressure is often a key feature of anaphylaxis and can lead to symptoms such as dizziness, fainting, confusion, and shock.