A nurse is caring for a client who overdosed on morphine and has a respiratory rate of 6/min. Which medication should the nurse plan to administer?

A) Inject a volume of less than 2 mL: While it is generally recommended to inject a volume of less than 2 mL into the deltoid muscle to avoid discomfort and ensure proper absorption, this is not the primary action to focus on when planning the injection.

B) Inject the medication at a 90 degree angle: This is the correct action. Administering an intramuscular (IM) injection at a 90-degree angle ensures that the medication is delivered deep into the muscle tissue, which is necessary for proper absorption and effectiveness.

C) Inject the medication 12.7 cm (5 in) below the client’s acromion process: The correct injection site for the deltoid muscle is typically 2-3 finger widths (approximately 2.5-5 cm) below the acromion process, not 12.7 cm. Injecting too far below the acromion process could result in an incorrect injection site.

D) Use a 21-gauge needle for the injection: While a 21-gauge needle can be used for IM injections, the gauge of the needle is not the primary focus in this context. The angle of injection is more critical to ensure proper delivery of the medication.

A. Transdermal patch:
A transdermal patch provides a slow, continuous release of medication over a period of time. While it is useful for long-term management of conditions, it does not provide the rapid onset needed for acute situations. The medication gradually enters the bloodstream through the skin, making it less effective for immediate relief.

B. Topical ointment:
Topical ointments are applied to the skin and are absorbed locally at the site of application. They are not designed for rapid systemic absorption and typically have a slower onset compared to other routes like sublingual or intravenous.

C. Suspended-release:
Suspended-release formulations are designed for controlled, extended-release of medication over time. These are not intended for rapid onset but rather for maintaining therapeutic levels of the medication over an extended period. They are suitable for long-term treatment rather than immediate relief.

D. Sublingual:
Sublingual administration (under the tongue) provides the most rapid onset for nitroglycerin. This route allows the medication to be absorbed directly into the bloodstream through the mucous membranes in the mouth, bypassing the gastrointestinal tract and first-pass metabolism in the liver. This results in a quick therapeutic effect, which is crucial for managing acute angina attacks.