A client with active GERD presents to clinic. Which statement by the client indicates they need additional education?

A) Opioid drugs are highly addictive, and the healthcare provider is concerned you will become addicted: While it is true that opioids have the potential for addiction, this response does not address the actual reason for the difference in morphine dosages. The provider's decision is likely based on the pharmacokinetics of the drug rather than a concern about addiction. This response could create unnecessary concern for the client and does not explain the dose discrepancy.

B) Morphine is highly bound to protein in your blood, and you are at risk for toxicity due to surgery: While morphine is protein-bound, the primary reason for the difference in the intravenous (IV) dose is not related to protein binding. The main difference is related to the route of administration and how the body processes the drug. The nurse should provide a more accurate explanation regarding the absorption and metabolism of morphine rather than focusing on protein binding or potential toxicity.

C) "Morphine taken by mouth passes through the liver, and some of the medication is made inactive": This is the best response. When morphine is taken orally, it is absorbed into the bloodstream and passes through the liver before reaching systemic circulation, a process known as the "first-pass effect." During this process, a portion of the drug is metabolized and rendered inactive, meaning that a higher oral dose is required to achieve the desired effect. When morphine is administered intravenously, it bypasses the liver and directly enters the bloodstream, leading to a more immediate and potent effect, which is why a lower dose is needed.

D) "The healthcare provider is cautious with opioids and starts low and adjusts the dose up as needed": While this is a valid approach to opioid prescribing, it doesn't fully explain why the client is receiving a smaller dose intravenously. The reason for the dose difference is based on the route of administration and the pharmacokinetic properties of the drug, not just a general cautious approach. This answer doesn't provide a clear explanation of why the IV dose is smaller.

A) "If you do not take it now, it will put you behind schedule.": While the nurse might be concerned about the medication schedule, this response dismisses the client's concern and doesn’t prioritize safety. The nurse should not pressure the client to take the medication before verifying that it is correct.
B) "Let me check the original order before you take it.": This is the best response because it demonstrates a commitment to patient safety. If the client is concerned about the medication, the nurse should take the time to verify the order directly from the original source to ensure the right medication is being given. This approach reassures the client and promotes trust.

C) "It wouldn't be listed here if it were not ordered for you!": This response can come across as dismissive and unprofessional. While it is important that the medication appears on the record, the nurse should still verify it to address the client's concern. Simply relying on the medication record without confirmation is not the best course of action.

D) "It's listed here on the medication sheet, so you should take it.": Similar to option C, this response dismisses the client’s concern and does not prioritize verifying the medication’s accuracy. It could lead to the client feeling their concerns were not taken seriously, which could negatively impact their trust in the care provided.