Question

A postoperative female client has a prescription for morphine sulfate 10 mg IV q3 hours for pain. One dose of morphine was administered when the client was admitted to the post anesthesia care unit (PACU) and 3 hours later, the client is again complaining of pain. Her current respiratory rate is 8 breaths/minute. What action should the nurse take?

Answer 1

The nurse should not administer another dose of morphine to the client with a respiratory rate of 8 breaths per minute, and should immediately attend to the client's respiratory status, and notify the healthcare provider as this is indicative of respiratory depression.

Step-by-step explanation:

The nurse should recognize that a respiratory rate of 8 breaths per minute is indicative of respiratory depression, which is a serious and potentially life-threatening side effect of opioids like morphine sulfate. Given this concern, the nurse should not administer another dose of morphine and should instead immediately assess the client's oxygen saturation and level of consciousness, provide supplemental oxygen as needed, and notify the healthcare provider. The appropriate action would often include holding the medication and monitoring vital signs closely. In severe cases of respiratory depression, it may be necessary to administer an opioid antagonist, such as naloxone, to reverse the effects of the morphine. Safety is the top priority when caring for a client with decreased respiratory function, especially postoperatively when they are at increased risk for complications.