A nurse is reviewing the medication list of a client who has bipolar disorder. The client is taking lithium carbonate, haloperidol, and lorazepam. The nurse should monitor the client for which of the following adverse effects?

A) Incorrect. Morphine sulfate does not need to be diluted in normal saline before administration. Diluting the medication can reduce its potency and effectiveness.

B) Correct. Morphine sulfate should be injected slowly over 1 to 2 minutes to prevent adverse effects, such as hypotension, respiratory depression, and nausea.

C) Incorrect. Heparin is not indicated for flushing the IV line before and after administration of morphine sulfate. Heparin is an anticoagulant that can increase the risk of bleeding. The IV line should be flushed with normal saline or sterile water to prevent medication incompatibility and ensure complete delivery of the medication.

D) Incorrect. The nurse should monitor the client's respiratory rate more frequently than every 15 minutes, as morphine sulfate can cause respiratory depression. The nurse should monitor the client's respiratory rate before, during, and after administration of the medication, and at least every 5 minutes until the client's pain is relieved.

A) Incorrect. Acetaminophen is a non-opioid analgesic that can be used safely with phenytoin. However, the nurse should advise the client to limit their intake of acetaminophen to no more than 4 g per day, as higher doses can cause liver toxicity.

B) Incorrect. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can be used safely with phenytoin. However, the nurse should advise the client to monitor for signs of bleeding, such as bruising, petechiae, and hematuria, as NSAIDs can inhibit platelet aggregation and increase the risk of bleeding.

C) Incorrect. Diphenhydramine is an antihistamine that can be used safely with phenytoin. However, the nurse should advise the client to avoid driving or operating machinery while taking diphenhydramine, as it can cause drowsiness and impair mental alertness.

D) Correct. Ginkgo biloba is an herbal supplement that can interact with phenytoin and reduce its effectiveness. Ginkgo biloba can induce hepatic enzymes that increase the metabolism and clearance of phenytoin, leading to subtherapeutic levels and increased risk of seizures.