Question

Your adult trauma patient is experiencing severe pain from a femur fracture. He is conscious, alert and oriented, with a heart rate of 120 per minute; his respirations are 28 per minute, and his blood pressure is 78/30. He is begging you to administer something for pain. He states he is allergic to Vicodin and aspirin.

Why would medical command most likely decline the request for morphine sulfate in this case?

A) The patient is asking for narcotics inappropriately
B) Because the Vicodin allergy makes morphine contraindicated
C) The morphine can worsen the bleeding associated with a femur fracture
D) Patient is hypotensive

Answer 1

The request for morphine is likely to be declined due to the patient's hypotensive state, as opioids can cause further lowering of blood pressure, which can be dangerous in trauma patients. The correct answer is Option D) Patient is hypotensive.

Step-by-step explanation:

Medical command would most likely decline the request for morphine sulfate because the patient is hypotensive, with a blood pressure of 78/30. Opioids like morphine can cause vasodilation leading to further lowering of blood pressure, which could be detrimental, especially in a trauma patient who may already be at risk for shock. Additionally, although allergies to Vicodin (which contains hydrocodone) do not directly contraindicate morphine, there may be a concern for cross-reactivity among opioid medications, and caution should be exercised when considering opioid administration in patients with known opioid allergies.