A nurse is collecting data from a client who is taking dimenhydrinate to treat motion sickness. Which of the following findings is an adverse effect of this medication?

A. "Instruct the client's visitors not to operate the PCA pump.” Only the client should press the PCA button to self-administer medication. Allowing visitors or family members to press the button ("PCA by proxy") increases the risk of over-sedation, respiratory depression, and opioid toxicity. The nurse should reinforce to visitors that only the client should control medication delivery based on their own pain level.

B. "Check the client's pain level every 8 hours." Pain assessment should be performed more frequently than every 8 hours when a client is receiving morphine PCA. Pain, sedation level, and respiratory status should be monitored every 1–2 hours initially and then at regular intervals as determined by hospital protocol to ensure effective pain management and prevent complications such as respiratory depression.

C. "Diarrhea is an adverse effect of morphine PCA." Morphine is an opioid analgesic that commonly causes constipation, not diarrhea. Opioids slow gastric motility, which can lead to delayed bowel movements, bloating, and discomfort. Clients on long-term opioid therapy often require stool softeners or laxatives to prevent opioid-induced constipation.

D. "Using morphine PCA increases the client's risk of toxicity." PCA pumps are designed with preset dose limits and lockout intervals to prevent overdose. While there is a risk of opioid toxicity if the system is misused (e.g., PCA by proxy or improper settings), PCA is actually safer than traditional opioid administration methods because it allows for precise dosing and patient-controlled pain management. Proper monitoring helps prevent complications.

A. Bleeding. Cefotetan, a second-generation cephalosporin, can interfere with vitamin K metabolism, leading to a decreased ability to form blood clots. When combined with NSAIDs, which have an antiplatelet effect, the risk of bleeding increases. Clients taking both medications should be monitored for bruising, prolonged bleeding, or signs of gastrointestinal hemorrhage such as black, tarry stools.

B. Dysrhythmias. Cefotetan and NSAIDs do not have significant cardiac effects that would lead to dysrhythmias. Some antibiotics, such as macrolides and fluoroquinolones, can cause QT prolongation, but cefotetan does not affect cardiac conduction.

C. Dizziness. While NSAIDs can sometimes cause dizziness as a side effect, this is not a significant interaction between cefotetan and NSAIDs. Cefotetan does not commonly cause dizziness unless associated with an allergic reaction or severe hypotension due to an adverse effect.

D. Jaundice. Cefotetan is metabolized by the liver, but it is not highly hepatotoxic and does not commonly cause jaundice. NSAIDs, when used long-term or in high doses, may contribute to liver dysfunction, but this is not a primary concern in the interaction between these two medications.