Intravenous morphine is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication? Select all that apply

Diarrhea

Constipation

Pruritus

Urinary frequency

Nausea

Answer and Explanation

Correct Answer : B,C,E

Morphine is a potent opioid analgesic commonly used for postoperative pain. While effective for pain relief, it has several predictable adverse effects due to its action on the central nervous system and gastrointestinal tract. Nurses must educate patients about these effects and implement strategies to manage or prevent them.

Rationale for correct answers:

B. Constipation:
Opioids decrease gastrointestinal motility, leading to constipation. Patients should be encouraged to increase fluid intake, dietary fiber, and activity, and stool softeners or mild laxatives may be prescribed prophylactically.

C. Pruritus:
Morphine can cause itching due to histamine release. This is usually mild but may require antihistamines if bothersome.

E. Nausea:
Opioids often stimulate the chemoreceptor trigger zone, leading to nausea and sometimes vomiting. Anti-emetic medications may be needed.

Rationale for incorrect answers:

A. Diarrhea:
Morphine decreases gut motility rather than increases it, making diarrhea uncommon unless the patient has other contributing factors.

D. Urinary frequency:
Opioids may cause urinary retention rather than increased frequency, due to relaxation of bladder detrusor muscles and increased sphincter tone.

Take-home points:

Constipation, pruritus, and nausea are common opioid adverse effects.
Preventive measures, such as stool softeners and antiemetics, should be part of patient teaching.
Monitor for these effects to ensure patient comfort and adherence to pain management therapy.

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Correct Answer is ["0.75"]

Explanation

Accurate dosage calculation is essential in nursing practice to ensure patient safety and effective pain management. When administering intravenous medications like morphine sulfate, the nurse must carefully convert the ordered dose into the correct volume based on the supplied concentration.

Rationale for correct answers:

Step-by-Step Calculation

To determine the volume of medication to administer, you can use the following formula:

Volume(mL)=ConcentrationSupplied(mg/mL)DoseOrdered(mg)

Identify the ordered dose: The order is for 3 mg of morphine sulfate.
Identify the concentration supplied: The vial is supplied as 4 mg/mL.
Calculate the volume: Volume(mL)=4mg/mL3mg=0.75mL

Therefore, the nurse will draw 0.75 mL into the syringe for this dose.

Take-home points:

Always use the formula: Volume (mL) = (Dose Ordered ÷ Dose on Hand) × Volume on Hand.
Double-check the medication concentration on the vial before calculating to avoid errors.
Correctly calculated, a 3 mg dose from a 4 mg/mL supply equals 0.75 mL to be drawn.

A. fentanyl B. naloxone C. butorphanol D. sufentanil

Correct Answer is B

Explanation

Hydromorphone is a potent opioid analgesic that, in overdose, can cause profound central nervous system and respiratory depression. In emergency situations, the priority is to restore adequate ventilation and prevent death. The specific antidote for opioid overdose is naloxone, an opioid receptor antagonist.

Rationale for correct answer:
B. Naloxone: Naloxone rapidly displaces opioids from the mu-opioid receptors in the CNS, reversing respiratory depression, sedation, and hypotension. It works within minutes when given IV, making it the drug of choice for opioid overdose emergencies.

Rationale for incorrect answers:
A. Fentanyl: Another opioid analgesic, fentanyl would worsen respiratory depression, not reverse it.
C. Butorphanol: This is a mixed agonist–antagonist opioid that can provide pain relief but will not reliably reverse life-threatening respiratory depression.
D. Sufentanil: An even stronger opioid analgesic than fentanyl, it would intensify opioid toxicity instead of reversing it.

Take-home points:

Naloxone is the antidote for all opioid overdoses, including hydromorphone.
It acts by blocking opioid receptors and rapidly restoring respiration.
Other opioids (fentanyl, sufentanil, butorphanol) do not reverse overdose and may worsen the condition.

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Intravenous morphine is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication? Select all that apply

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is administering an intravenous dose of morphine sulfate to a 48-year-old postoperative patient. The dose ordered is 3 mg every 3 hours as needed for pain. The medication is supplied in vials of 4 mg/mL. How much will be drawn into the syringe for this dose?

Correct Answer is ["0.75"]

Explanation

A patient is admitted to the emergency department in respiratory depression following self-injection with hydromorphone. The admitting nurse knows that which drug will reverse respiratory depression caused by opioid overdose?

Correct Answer is B

Explanation

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