A nurse in a coronary care unit is admitting a client who has had CPR following a cardiac arrest. The client is receiving lidocaine IV at 2 mg/min. When the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions?

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.

Choice A reason: Ototoxicity is not a severe reaction to propranolol, but it may occur with some other medications, such as aminoglycosides, loop diuretics, or salicylates. Ototoxicity may damage the inner ear or the auditory nerve and cause hearing loss, tinnitus, or vertigo. The nurse should assess the client's medication history and monitor the client's hearing function.

Choice B reason: Hypokalemia is not a severe reaction to propranolol, but it may occur with some other medications, such as thiazide diuretics, corticosteroids, or insulin. Hypokalemia may cause muscle weakness, cramps, arrhythmias, or cardiac arrest. The nurse should advise the client to eat foods rich in potassium, such as bananas, oranges, or potatoes, and to have regular blood tests to check the electrolyte levels.

Choice C reason: Tachycardia is not a severe reaction to propranolol, but it may be a sign of overdose, withdrawal, or rebound effect. Propranolol is a beta-blocker that lowers the heart rate and blood pressure by blocking the effects of epinephrine and norepinephrine. Propranolol may cause bradycardia, not tachycardia, as a side effect. The nurse should monitor the client's vital signs and advise the client to take the medication as prescribed and not to stop it abruptly.

Choice D reason: Postural hypotension is a severe reaction to propranolol, as it may cause dizziness, fainting, or falls. Postural hypotension occurs when the blood pressure drops significantly when the client changes position, such as from lying to sitting or standing. Propranolol may cause postural hypotension by reducing the vascular tone and the cardiac output. The nurse should instruct the client to change position slowly and to report any symptoms of postural hypotension to the provider.