A nurse is administering the first dose of ramipril to a client who has hypertension.
The client reports feeling dizzy and lightheaded.
Which of the following should the nurse administer?

Choice A rationale:

Donepezil is a medication used to treat symptoms of Alzheimer’s disease and does not typically cause urinary retention.

Choice B rationale:

Scopolamine, an anticholinergic drug, can cause urinary retention. Anticholinergic drugs block the action of acetylcholine, a neurotransmitter that helps to contract the bladder muscles and relax the urinary sphincters to allow urination.

Choice C rationale:

Metoprolol is a beta-blocker used to treat high blood pressure and heart problems. It does not typically cause urinary retention.

Choice D rationale:

Acetaminophen is a common over-the-counter pain reliever and does not typically cause urinary retention.

Choice A rationale:

Dry mouth is a common side effect of diphenhydramine. Diphenhydramine is an antihistamine that is often used to treat allergies, insomnia, and symptoms of the common cold. It works by blocking the effects of histamine, a substance in the body that causes allergy symptoms. One of the effects of histamine is increased salivation, so when diphenhydramine blocks this effect, it can lead to dry mouth.

Choice B rationale:

Nausea is also a common side effect of diphenhydramine. This can occur because diphenhydramine can slow down the emptying of the stomach, leading to feelings of nausea. Additionally, diphenhydramine can affect the vestibular system in the inner ear, which can also lead to feelings of nausea.

Choice C rationale:

Agitation is considered an idiosyncratic reaction to diphenhydramine. An idiosyncratic reaction is an unusual or unexpected reaction to a drug that is not related to the usual pharmacological action of the drug. While diphenhydramine is typically used for its sedative effects, in some cases it can cause paradoxical central nervous system stimulation, leading to agitation.

Choice D rationale:

Dizziness is another common side effect of diphenhydramine. This occurs because diphenhydramine can affect the vestibular system in the inner ear, which plays a key role in maintaining balance. When this system is affected, it can lead to feelings of dizziness.