A patient receiving Morphine for postoperative pain relief displays slow, shallow breathing with a rate of 8 breaths/minute. The nurse recognizes this as a side effect called:

Choice A reason: Vitamin C supplements are not a concern for the concurrent use with Lorazepam, which is a medication that reduces anxiety and insomnia by enhancing the effects of a neurotransmitter called gammaaminobutyric acid (GABA) in the brain¹. Vitamin C is an essential nutrient that supports the immune system and the synthesis of collagen, a protein that forms the connective tissue in the body. Vitamin C does not interact with Lorazepam or affect its metabolism or clearance.

Choice B reason: Caffeinated beverages are not a concern for the concurrent use with Lorazepam, but they may reduce its effectiveness or cause unwanted effects. Caffeine is a stimulant that increases the activity of the central nervous system and counteracts the sedative and calming effects of Lorazepam. Caffeine may also cause side effects such as nervousness, insomnia, or palpitations, especially in high doses or in sensitive individuals. The nurse should advise the patient to limit or avoid caffeine intake while taking Lorazepam, and to monitor their response to the medication.

Choice C reason: Alcohol is a concern for the concurrent use with Lorazepam, as it can increase the risk of serious and potentially fatal side effects. Alcohol is a depressant that slows down the activity of the central nervous system and enhances the effects of Lorazepam. Alcohol can cause additive effects such as excessive sedation, respiratory depression, coma, or death when taken with Lorazepam. The nurse should advise the patient to avoid alcohol consumption while taking Lorazepam, and to seek immediate medical attention if they experience any signs of overdose or toxicity.

Choice D reason: Dairy products are not a concern for the concurrent use with Lorazepam, as they do not affect its absorption, distribution, metabolism, or excretion. Dairy products are a source of calcium, protein, and other nutrients that support the bone health and the muscle function. Dairy products do not interact with Lorazepam or alter its pharmacokinetics or pharmacodynamics.

Choice A reason: Bradycardia is not an adverse effect of diphenhydramine. Diphenhydramine is a medication that blocks the action of histamine, a chemical that causes allergic reactions and inflammation. Diphenhydramine can also block the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Diphenhydramine does not affect the heart rate or blood pressure significantly, and it is not associated with bradycardia, which is a slow heart rate that can cause dizziness, fatigue, or fainting. The nurse should monitor the vital signs of the client after administering diphenhydramine, but bradycardia is not a common or expected outcome.

Choice B reason: Sedation is an adverse effect of diphenhydramine. Diphenhydramine is a medication that blocks the action of histamine, a chemical that causes allergic reactions and inflammation. Diphenhydramine can also block the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Diphenhydramine can cross the bloodbrain barrier and block the histamine receptors in the brain, which are involved in regulating the sleepwake cycle and alertness. Diphenhydramine can cause sedation, sleepiness, drowsiness, dizziness, and impaired coordination, which can affect the performance and safety of the client. The nurse should instruct the client to avoid driving, operating machinery, or performing other tasks that require mental alertness after taking diphenhydramine, and to take the medication at bedtime or as needed for sleep.

Choice C reason: Constipation is not an adverse effect of diphenhydramine. Diphenhydramine is a medication that blocks the action of histamine, a chemical that causes allergic reactions and inflammation. Diphenhydramine can also block the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Diphenhydramine does not affect the gastrointestinal motility or secretion significantly, and it is not associated with constipation, which is a condition of infrequent or difficult bowel movements. The nurse should encourage the client to eat a balanced and highfiber diet, drink plenty of fluids, and exercise regularly to prevent or treat constipation, but diphenhydramine is not a contributing factor.

Choice D reason: Hypertension is not an adverse effect of diphenhydramine. Diphenhydramine is a medication that blocks the action of histamine, a chemical that causes allergic reactions and inflammation. Diphenhydramine can also block the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Diphenhydramine does not affect the blood pressure or the vascular tone significantly, and it is not associated with hypertension, which is a condition of high blood pressure that can cause headaches, chest pain, or stroke. The nurse should monitor the blood pressure of the client after administering diphenhydramine, but hypertension is not a common or expected outcome.