What immediate care should be provided for a patient demonstrating difficult breathing with hives?

In the scenario where a patient is experiencing difficult breathing accompanied by hives, administering Epinephrine intramuscularly is the most appropriate immediate care. This situation suggests a potential anaphylactic reaction, where the body reacts severely to an allergen. Anaphylaxis often presents with symptoms such as respiratory distress, hives (urticaria), swelling, and other allergic reactions.

Epinephrine acts as a potent vasoconstrictor and bronchodilator. It helps to relieve airway constriction, reduces swelling, and improves breathing by opening up the airways. This rapid intervention is critical in managing anaphylaxis, as it can quickly reverse life-threatening symptoms and stabilize the patient.

Other options, while they may have their place in different scenarios, do not address the immediate danger posed by anaphylaxis effectively. Providing supplemental oxygen might be helpful for respiratory distress but does not address the underlying cause. Encouraging deeper breathing is ineffective in a situation requiring urgent intervention, and beginning CPR would be inappropriate unless the patient is unresponsive with no pulse, since the primary issue here is the airway and breathing, not cardiac arrest. Therefore, the most effective and necessary immediate care in this case is the administration of Epinephrine.