A patient receiving IV vancomycin (Vancocin) complains of facial pruritus. Which action should the nurse implement to prevent pruritus associated with vancomycin?

Vancomycin infused too rapidly causes a well-known adverse reaction called Red Man Syndrome, characterized by flushing, erythema, and pruritus of the face, neck, and upper torso. This reaction is not a true allergic or hypersensitivity response; it is an infusion rate-related phenomenon caused by histamine release triggered by rapid administration. The standard prevention is to infuse vancomycin slowly, over at least 60 minutes, and many protocols recommend 90 minutes for larger doses. Slowing the rate significantly reduces histamine release and prevents the pruritus and flushing. Diphenhydramine may be used to treat an already-occurring reaction but is not the primary preventive action and does not address the root cause. Documenting a hypersensitivity reaction would be inaccurate because Red Man Syndrome is not a true hypersensitivity; mislabeling it could inappropriately preclude future use of the drug. Wrapping the infusion in foil is relevant for light-sensitive drugs such as nitroprusside and is irrelevant here. Therefore, the correct preventive intervention is to administer vancomycin over at least one hour, which is the evidence-based nursing action to prevent infusion rate-related histamine release and its associated cutaneous symptoms.