The nurse is caring for a patient with a suspected methicillin resistant staphylococcal aureus (MRSA) skin infection. While awaiting wound cultures and sensitivities, the patient is empirically given vancomycin. When the nurse starts the IV infusion of vancomycin, the patient acutely develops a pruritic, erythematous rash that involves the face, neck and upper torso. Which action does the nurse take first?

The nurse anticipates seeing the effect of which medication most quickly? 

The nurse assesses the insertion site of an intravenous catheter through which the patient is receiving amphotericin. The nurse notes erythema, edema, and tenderness immediately proximal to the insertion site. Which of the following terms is most appropriate for the nurse to use to document this finding?