A nurse is caring for a client who has a prescription for penicillin V. Which of the following adverse effects is the priority for the nurse to monitor after the administration of the medication?

Choice A rationale Laryngeal edema is a severe manifestation of an immediate hypersensitivity (Type I anaphylactic) reaction to penicillin. It involves swelling of the larynx, leading to airway obstruction, stridor, and difficulty breathing. This life-threatening condition requires immediate medical intervention, including epinephrine and airway management, making it the priority to monitor. Choice B rationale Urticaria, or hives, is a common cutaneous manifestation of a hypersensitivity reaction to penicillin. It involves transient, itchy wheals on the skin due to histamine release. While uncomfortable and requiring attention, it is typically not life-threatening unless accompanied by systemic symptoms like laryngeal edema or bronchospasm. Choice C rationale Epigastric distress, such as stomach upset or pain, is a common gastrointestinal adverse effect of oral penicillin V, often due to direct irritation of the gastric mucosa or altered gut flora. While it can cause discomfort, it is generally not a life-threatening condition and can often be managed with food or dose adjustment. Choice D rationale Maculopapular rash is a delayed hypersensitivity reaction to penicillin, usually appearing several days after initiation of therapy. It presents as flat, red areas with small raised bumps. While it indicates a drug allergy, it is generally not immediately life-threatening compared to acute airway compromise and resolves upon discontinuation of the medication.