Nursing Implications of Morphine Sulfate Administration

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Questions and Answers

What is an appropriate nursing implication when administering morphine sulfate to a postoperative client?

Administer the medication as needed

Give the medication only during the day

Determine respiratory rate, blood pressure, pulse rate, and pain score before administration (correct)

Skip the initial dose if the client has a history of substance abuse

What is a risk associated with estrogen progesterone therapy for women after menopause?

Risk of stroke, blood clots, and heart attack (correct)

Risk of osteoporosis

Risk of depression

Risk of migraines

Why is it important to evaluate for urinary retention when administering morphine sulfate?

To monitor for urinary retention (correct)

To monitor for hypertension

To monitor for respiratory depression

To monitor for allergic reactions

What is a change in gastrointestinal function in older adult clients?

Leading to an increase in serum drug levels Signup and view all the answers

What is a common reason for nonadherence to medications among older adult clients?

Due to cost of medications Signup and view all the answers

What is a risk associated with estrogen progesterone therapy for women after menopause besides stroke, blood clots, and heart attack?

Risk of breast cancer Signup and view all the answers

Why is it important to give morphine on a fixed schedule around the clock during the first 24 hours postoperatively?

To manage pain during the first 24 hours postoperatively Signup and view all the answers

What is a common adverse drug reaction in older adult clients?

Altered renal function Signup and view all the answers

What changes in older adult clients can lead to an increase in serum drug levels?

Changes in gastrointestinal function Signup and view all the answers

Why is nonadherence for medications common among older adult clients?

Due to the cost of medications Signup and view all the answers

Which client should the nurse assess first?

A 70-year-old woman with an elevated creatinine level Signup and view all the answers

What instruction should the nurse provide to a client starting therapy with digoxin?

Take pulse daily Signup and view all the answers

When should the nurse hold a medication?

When the client has bradycardia Signup and view all the answers

What are preventable causes of medication errors?

Confusing drugs with similar packaging Signup and view all the answers

Which client requires immediate attention from the nurse?

A client who received an ordered dose of insulin glargine the night before surgery Signup and view all the answers

Why should the nurse closely monitor a client receiving digoxin?

To monitor for potential adverse effects Signup and view all the answers

What variables can affect a client's response to a drug?

Both A and B Signup and view all the answers

What interventions should the nurse implement for a client suspected of having a myocardial infarction (MI)?

Administer the morphine sulfate slowly over 5 minutes Signup and view all the answers

What is the primary concern for a client who received insulin glargine the night before surgery?

Hypoglycemia Signup and view all the answers

What intervention should the nurse implement for a client taking erythropoietin for chronic kidney disease?

All of the above Signup and view all the answers

Why should the nurse prioritize the client who requires a chlorhexidine scrub prior to surgery?

To prevent surgical site infections Signup and view all the answers

Which medications can be safely resumed after pregnancy?

Atenolol Signup and view all the answers

When taking herbal remedies, what should the client do?

Consult the provider before taking aspirin Signup and view all the answers

Why might the client's warfarin dose need to be readjusted?

When taking a course of antibiotics Signup and view all the answers

What is an incorrect statement about taking potassium?

Take potassium with furosemide together Signup and view all the answers

What is a potential side effect of taking clopidogrel?

Bleeding may increase when taken with aspirin Signup and view all the answers

What is a critical finding to report immediately in a client receiving a continuous infusion of heparin?

Evidence of dark, tarry stools Signup and view all the answers

What should the client be taught when preparing for discharge with a prescription for amiodarone?

Expect a yellow discoloration to the skin Signup and view all the answers

What is a potential long-term effect of taking warfarin?

Hyperthyroidism Signup and view all the answers

What is a correct statement about taking furosemide?

Take furosemide with food Signup and view all the answers

Which laboratory data should the nurse evaluate when a client is taking clozapine?

Therapeutic level of clozapine Signup and view all the answers

Which medication is the drug of choice for treating malignant hyperthermia?

Dantrolene Signup and view all the answers

What is a characteristic of a medication with a narrow therapeutic index?

Dose changes must be monitored closely to prevent toxicity Signup and view all the answers

A client with decreased cardiac output would most likely have impairment of which pharmacokinetic process?

Distribution Signup and view all the answers

Why is it essential to follow safe medication administration when administering intravenous (IV) medications?

Control over the levels of drug in the body is unpredictable Signup and view all the answers

What is a characteristic of a medication with a low therapeutic index?

The highest dose needed to produce a therapeutic effect is close to the lethal dose Signup and view all the answers

Which client is at the highest risk for the development of drug toxicity?

A client taking a medication with a narrow therapeutic index Signup and view all the answers

What is the primary reason for closely monitoring dose changes of medications with a narrow therapeutic index?

To prevent toxicity Signup and view all the answers

Study Notes

Morphine Sulfate Administration

Before administering morphine sulfate, determine respiratory rate, blood pressure, pulse rate, and pain score.
Morphine should be given on a fixed schedule around the clock during the first 24 hours postoperatively.
The nurse should evaluate for urinary retention every 4 to 6 hours while on this medication.

Estrogen Progesterone Therapy Risks

Risks associated with estrogen progesterone therapy for women after menopause include:
- Stroke
- Blood clots
- Heart attack
- Breast cancer
- Lung cancer

Medication Administration in Older Adults

Changes in gastrointestinal function in older adult clients can lead to an increase in serum drug levels.
Many adverse drug reactions in older adult clients are related to altered renal function.
Nonadherence for medications among older adult clients is often due to the cost of medications.

Atenolol Administration

The nurse should hold atenolol medication in the following situations:
- Bradycardia
- A blood pressure of 78/40 mmHg

Preventable Causes of Medication Errors

Preventable causes of medication errors include:
- Confusing drugs with similar packaging
- Giving a drug intravenously instead of intramuscularly
- Complicated drugs with names that look or sound alike
- Writing a prescription that is unreadable

Variables Affecting Client Response to a Drug

Variables that can help determine the client's response to a drug include:
- Liver disease
- Age
- Genetic factors
- Gender

Myocardial Infarction (MI) Interventions

Interventions for a client suspected of having a myocardial infarction (MI) and ordered morphine sulfate for pain include:
- Instructing the client not to get out of bed without notifying the nurse
- Diluting the morphine sulfate to a 10 mL bolus with normal saline
- Administering the morphine sulfate slowly over 5 minutes

Erythropoietin Administration

Interventions for a client diagnosed with chronic kidney disease and prescribed erythropoietin include:
- Monitoring the client's complete blood cell (CBC) count
- Teaching the client to pace activities
- Monitoring blood pressure while taking this medication

Medication Resumption after Pregnancy

Medications that can safely be resumed after pregnancy that were contraindicated during pregnancy include:
- (Not specified in the provided text)

Prioritizing Clients

The nurse should prioritize clients based on their condition and needs, such as:
- A client with a blood pressure of 110/85 mmHg taking digoxin
- A client who has received insulin glargine the night before and is scheduled for surgery
- A client with a history of rheumatoid arthritis complaining of 5/10 pain in the joints of their hands
- A client who requires a chlorhexidine scrub prior to a double mastectomy

Digoxin Therapy

Instructions for a client beginning therapy with digoxin include:
- Taking pulse daily
- Monitoring electrolyte levels regularly
- Monitoring blood pressure regularly

Warfarin Therapy

Instructions for a client taking warfarin include:
- Expecting a yellow discoloration to the skin and using sunblock if this occurs
- Reporting any blue tint to the skin, which may indicate venous insufficiency
- Monitoring thyroid labs while taking this medication, as it can cause hyperthyroidism

Medication Administration Safety

The nurse should follow safe medication administration practices, particularly when administering intravenous (IV) medications, because:
- The IV route results in a rapid onset of action
- Control over the levels of drug in the body is unpredictable
- Dose changes must be monitored closely to prevent toxicity

Medication Toxicity

The nurse should monitor for adverse drug reactions and consider the client most at risk for drug toxicity to be:
- A client with decreased cardiac output, which can impair distribution of the medication
- A client with a history of hypertension taking furosemide and potassium
- A client taking warfarin for atrial fibrillation
- A client taking clopidogrel for atrial fibrillation

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Description

This quiz assesses the nurse's understanding of the correct administration and monitoring of morphine sulfate in a postoperative client. It covers the essential nursing implications associated with this medication.