A nurse is teaching a client who has angina about nitroglycerin sublingual tablets. Which of the following statements should the nurse include in the teaching?

Choice A reason: Bradycardia is not an adverse effect of diphenhydramine. Bradycardia is a slow heart rate, usually below 60 beats per minute. Diphenhydramine is an antihistamine that blocks the effects of histamine, a chemical that causes allergic reactions. Diphenhydramine does not affect the heart rate, although it may cause palpitations or irregular heartbeat in some cases.

Choice B reason: Constipation is an adverse effect of diphenhydramine. Constipation is a condition in which the bowel movements are infrequent, hard, or difficult to pass. Diphenhydramine has anticholinergic properties, which means it inhibits the activity of acetylcholine, a neurotransmitter that regulates the smooth muscle contraction in the gastrointestinal tract. Diphenhydramine can reduce the intestinal motility and cause constipation, as well as dry mouth, blurred vision, and urinary retention.

Choice C reason: Hypertension is not an adverse effect of diphenhydramine. Hypertension is a condition in which the blood pressure is abnormally high, usually above 140/90 mmHg. Diphenhydramine does not affect the blood pressure, although it may cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions from lying to standing. This can cause dizziness, fainting, or falls.

Choice D reason: Sedation is an adverse effect of diphenhydramine. Sedation is a state of reduced alertness, awareness, or responsiveness. Diphenhydramine can cross the blood-brain barrier and affect the central nervous system, causing drowsiness, fatigue, impaired coordination, and reduced mental performance. Diphenhydramine can also potentiate the effects of alcohol and other sedatives, such as benzodiazepines, opioids, or barbiturates. The nurse should advise the client to avoid driving, operating machinery, or performing other tasks that require attention and concentration while taking diphenhydramine.

Choice A reason: Suppressing respiratory effort is the correct purpose of pancuronium. Pancuronium is a neuromuscular blocking agent that paralyzes the skeletal muscles, including the respiratory muscles. This prevents the client from breathing spontaneously and allows the mechanical ventilator to control the ventilation. Pancuronium is used to improve oxygenation and prevent barotrauma in clients with ARDS, who have severe hypoxemia and stiff lungs.

Choice B reason: Decreasing chest wall compliance is not the correct purpose of pancuronium. Chest wall compliance is the measure of how easily the chest wall expands during inspiration. Decreasing chest wall compliance means increasing the resistance to lung expansion, which can worsen the ventilation and oxygenation in clients with ARDS. Pancuronium does not affect the chest wall compliance, but rather the muscle tone.

Choice C reason: Decreasing respiratory secretions is not the correct purpose of pancuronium. Respiratory secretions are the mucus and fluid that are produced by the respiratory tract to moisten and protect the airways. Decreasing respiratory secretions can cause dryness and irritation of the mucous membranes, which can increase the risk of infection and inflammation. Pancuronium does not affect the respiratory secretions, but rather the nerve impulses.

Choice D reason: Inducing sedation is not the correct purpose of pancuronium. Sedation is a state of reduced consciousness, awareness, or responsiveness. Inducing sedation can help to reduce anxiety, pain, and agitation in clients who are mechanically ventilated. Pancuronium does not induce sedation, but rather paralysis. Pancuronium does not affect the central nervous system, but rather the peripheral nervous system. The nurse should administer a sedative agent, such as propofol or midazolam, along with pancuronium to ensure the client's comfort and safety.