An adult of about 70 kg develops wheeze, facial swelling and hypotension two minutes after an IV antibiotic starts. After stopping the infusion, which first-line drug and route should the nurse prepare?

Answer and explanation

Correct answer: B. Epinephrine 0.5 mg (1 mg/mL) intramuscularly into the anterolateral thigh

  1. Step 1: The picture is anaphylaxis, in which epinephrine is the first-line treatment.
  2. Step 2: The adult dose is 0.5 mg of 1 mg/mL epinephrine intramuscularly in the mid-outer thigh, repeated as ordered.
Answer
Epinephrine 0.5 mg IM into the thigh.
Why not the others: Intravenous push is reserved for monitored arrest or refractory shock with dilute solutions; antihistamines and steroids are second-line; subcutaneous absorption is slower and unreliable.

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