A nurse is assessing a client who is receiving a dose of IV amphotericin B. Which of the following findings should indicate to the nurse that the client is experiencing an acute infusion reaction?

Amphotericin B is a potent polyene antifungal used for systemic mycoses, known for its significant toxicity. It frequently causes an acute infusion-related reaction due to the release of pro-inflammatory cytokines such as TNF-alpha and interleukin-1 during the intravenous administration process. Rationale: A. Pedal edema is not typically a sign of an acute infusion reaction; rather, it may indicate renal impairment or fluid volume overload. While amphotericin B is notoriously nephrotoxic, which can eventually lead to fluid retention, this is a chronic complication rather than an immediate reaction. Acute reactions are characterized by systemic inflammatory signs occurring within 1 to 3 hours. B. A dry cough is not a classic manifestation of an acute infusion reaction to amphotericin B. Respiratory symptoms like dyspnea or tachypnea can occur in severe cases, but they are usually accompanied by more prominent signs of inflammation. A dry cough would more likely be associated with other drug classes, such as ACE inhibitors or pulmonary complications. C. Fever is a hallmark sign of an acute amphotericin B infusion reaction, often accompanied by chills, rigors, and headache. This occurs as the drug triggers a systemic inflammatory response shortly after the infusion begins. Nurses often pre-medicate clients with antipyretics and antihistamines to mitigate these distressing symptoms, which are sometimes colloquially referred to as "shake and bake." D. Hyperglycemia is not an expected adverse effect of amphotericin B therapy. The drug primarily impacts renal function and electrolyte balance, specifically causing hypokalemia and hypomagnesemia. Glucose metabolism is not typically altered by polyene antifungals. If hyperglycemia occurs, the nurse should investigate other factors such as the client's intravenous maintenance fluids or underlying diabetic status.