The practical nurse (PN) evaluates a client 30 minutes after the initial administration of a new prescription. Which client response requires immediate action by the PN?

A. Tinnitus and vertigo after taking an aminoglycoside antiinfective: These are signs of ototoxicity, which are serious but typically develop after repeated dosing rather than immediately. Monitoring and reporting are important, but urgent intervention is less critical than acute hypersensitivity reactions. B. Pruritus and urticaria after receiving a broad-spectrum antibiotic: These symptoms suggest an allergic reaction, which can progress rapidly to anaphylaxis. Immediate assessment, discontinuation of the drug, and notification of the healthcare provider are critical to prevent life-threatening complications. C. Restlessness and excitability after receiving a narcotic analgesic: Mild restlessness can occur as a side effect, but it is usually not life-threatening. Continuous monitoring is appropriate, but it does not require the same immediate action as an allergic reaction. D. Orthostatic hypotension and bradycardia after taking a beta blocker: These are known effects of beta blockers and should be monitored. While they may require intervention if severe, they are typically predictable and not immediately life-threatening compared to acute allergic responses.