A 7 year old female complains that her hands and forehead are itchy after being prescribed antibiotics for an ear infection. Vital signs are normal. What should you administer?

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Managing a mild allergic reaction presenting with itching and potential hives in a child is best addressed with an antihistamine. The itch and any hive-type rash come from histamine release, which antihistamines like diphenhydramine block by inhibiting the H1 receptors, providing quick relief of itching and urticaria. Since the child’s vital signs are normal and there are no airway symptoms or signs of anaphylaxis, epinephrine is not indicated right now. The other options don’t address itching and rash: an inhaled with bronchodilator would be for wheezing or bronchospasm, and acetaminophen treats fever or pain but not allergic symptoms. If symptoms worsen, such as swelling of the face or tongue, trouble breathing, or fainting, escalate to emergency care promptly.