A nurse is caring for a client who will be having surgery. Which of the following is a nurse's role when obtaining informed consent?

Rationale:
A. Morphine typically causes miosis (constricted pupils), not dilation. A pupil diameter of 6 mm (dilated pupils) is not an expected therapeutic effect, but it is not the most immediately life-threatening finding in this scenario compared with severe hypotension.

B. This equates to about 30 mL/hr, which is borderline low but still may be acceptable depending on the client’s weight, hydration status, and clinical context. Morphine can also cause urinary retention, so this finding should be monitored but is not the priority.

C. Constipation is a very common adverse effect of morphine due to decreased gastrointestinal motility. While important to address with stool softeners or laxatives, it is not an acute emergency.

D. This is the priority finding because it indicates severe hypotension, which can lead to decreased tissue perfusion, shock, and organ failure. Morphine can cause vasodilation and histamine release, contributing to hypotension, especially when given IV. This requires immediate intervention and provider notification first, as it is life-threatening.

A. Hydrochlorothiazide is a thiazide diuretic commonly prescribed for hypertension and edema. The dose of 12.5 mg twice daily is within an acceptable range. Although diuretics are often given in the morning to prevent nocturia, this order is clear and complete, so no clarification is required.

B. Zolpidem is a sedative-hypnotic used for insomnia. The prescription clearly states the dose, route, and timing (at bedtime). This is a standard and complete order.

C. This is a nasal corticosteroid used for allergic rhinitis. The prescription includes the medication, dose, route (intranasal), frequency, and specific instructions, making it clear and appropriate.

D. The nurse should clarify this prescription because the dose is written as “.5 mg” without a leading zero. According to safe medication administration practices, a leading zero (0.5 mg) must be used to prevent dosing errors. Without it, the dose could be misread as 5 mg, which could result in overdose. This violates safety standards and requires clarification before administration.