The nurse is planning to administer morphine to an adult client. Which clinical finding should concern the nurse?

A. Assessment: Asking about medication allergies is part of the data-gathering phase of the nursing process. This step involves collecting subjective and objective information to identify factors that may affect pharmacologic safety, including hypersensitivity reactions or previous adverse responses that could contraindicate medication therapy.

B. Implementation: Implementation refers to carrying out interventions such as administering medications or providing teaching. Since the nurse is gathering information rather than performing an intervention, this phase is not being used.

C. Planning: Planning involves developing goals and selecting interventions based on assessment data. The nurse cannot begin planning until allergy information and other relevant data have already been collected, so this step does not apply.

D. Diagnosis: Nursing diagnosis involves analyzing assessment data to identify client problems or risks. Asking about allergies occurs before this analytical step and therefore belongs to the assessment phase.

A. The client reports increased hunger: Hunger can occur as blood glucose begins to fall, but it is an early and nonspecific adrenergic sign and may not reliably indicate clinically significant hypoglycemia. It requires monitoring but is less urgent than symptoms linked to neuroglycopenia or autonomic overactivation.

B. The client reports palpitations: Palpitations reflect sympathetic nervous system activation due to rapid declines in plasma glucose, triggering catecholamine release. This response occurs during acute hypoglycemia and signals that glucose levels may be dropping to a dangerous range, requiring immediate assessment and intervention.

C. The client reports a headache: Headache may develop with hypoglycemia but tends to occur later as neuroglycopenia progresses. It is less specific and does not usually precede severe or acute hypoglycemic episodes as reliably as adrenergic symptoms such as palpitations or tremors.

D. The client reports joint pain: Joint pain is not physiologically associated with hypoglycemia and is unrelated to insulin’s metabolic effects. It does not reflect glucose fluctuations or autonomic activation and therefore would not prompt hypoglycemia assessment.