A nurse is caring for a client who is experiencing complications from ephedra. Which of the following is an adverse effect of ephedra?

A. Ephedra is a stimulant herb that can increase heart rate and blood pressure, placing significant strain on the cardiovascular system. Adverse effects include myocardial infarction, stroke, arrhythmias, and hypertension. These serious cardiovascular events are well-documented and the primary concern with ephedra use. B. Erectile dysfunction is not a known direct adverse effect of ephedra. While cardiovascular issues could indirectly affect sexual function, it is not commonly reported as a primary complication. C. Ephedra is not hepatotoxic in a way that causes cirrhosis. Liver damage is not a common adverse effect of ephedra; hepatotoxicity is associated with other herbal supplements, such as kava or certain weight-loss products, but not ephedra.