A nurse is caring for a client. Exhibits Select the 4 findings that require immediate follow-up.

A. Heart rate: The client's heart rate increased significantly from 66/min to 104/min within 30 minutes of antibiotic administration. This tachycardia, especially in the context of other alarming symptoms, can indicate a compensatory mechanism for hypoperfusion due to vasodilation, a common feature of anaphylaxis. B. Blood pressure: The client’s blood pressure has dropped significantly from 108/56 mm Hg to 88/56 mm Hg. Hypotension could be a sign of anaphylactic shock, especially considering the allergic symptoms (urticaria, swelling of the tongue). C. Breath sounds: The presence of wheezing along with a drop in oxygen saturation (pulse oximetry 93%) is concerning for bronchospasm, which is common in allergic reactions or anaphylaxis. The client may need immediate airway management, including bronchodilators. D. Urticaria: While urticaria (hives) is a classic sign of an allergic reaction, it is a skin manifestation and not as immediately life-threatening as airway compromise, hypotension, or a compensatory tachycardia. E. Temperature: The temperature remains within a mild range (37.5°C/99.5°F to 37.6°C/99.7°F). It is slightly elevated but not concerning in the context of an allergic reaction. The temperature should be monitored but does not require immediate follow-up compared to the more critical findings. F. Swollen tongue: Swelling of the tongue is a serious symptom of an allergic reaction and can lead to airway obstruction. Immediate intervention is required to prevent further complications, such as anaphylaxis, which can be life-threatening.