The provider has ordered intramuscular (IM) injections of morphine, a narcotic, every 4 hours as needed for pain in a motor vehicle accident victim.
The nurse is aware this drug has a high abuse potential.
Under what category would morphine be classified?

Choice A rationale

A patient 3 days after surgery may still require higher doses of opioids for pain management, but the duration and intensity of postoperative pain typically decrease over time. This patient may not necessarily require a higher-than-expected dose compared to others.

Choice B rationale

Patients with cancer often experience severe and chronic pain due to the disease itself or its treatments. These patients may develop tolerance to opioids over time, necessitating higher-than-expected doses to achieve adequate pain relief.

Choice C rationale

Hypotension is a contraindication for high doses of opioids, as opioids can cause further blood pressure reduction. This patient would require careful dose adjustment to avoid exacerbating hypotension.

Choice D rationale

Patients with a concussion are at risk of altered mental status and respiratory depression from opioids. Therefore, higher doses are generally avoided to prevent worsening of these conditions.

Choice A rationale

Increased jugular venous pressure is more commonly associated with right-sided heart failure, where blood backs up into the venous system.

Choice B rationale

Liver enlargement is also indicative of right-sided heart failure due to congestion of the liver blood vessels.

Choice C rationale

Increased pulse rate can occur in both left and right-sided heart failure but is not a specific indicator of worsening left-sided failure.

Choice D rationale

Increased crackles in lung fields indicate fluid accumulation in the lungs, a sign of worsening left-sided heart failure. Left-sided heart failure leads to pulmonary congestion due to inadequate pumping of blood from the left ventricle.