NCLEX-PN® ExaminationPharmacological TherapiesHard
A client is prescribed morphine sulfate for severe postoperative pain. The LPN assesses the client 30 minutes after administration. Which finding is the most critical to report immediately to the registered nurse (RN) or healthcare provider?
- AClient states feeling drowsy.
- BClient rates pain as 4/10 after initial 8/10.
- CClient reports mild constipation.
- DRespiratory rate is 8 breaths/minute.
Show answer & explanationAnswer & explanation
Correct answer: D. Respiratory rate is 8 breaths/minute.
Opioid analgesics like morphine can cause respiratory depression, which is characterized by a decreased respiratory rate. A respiratory rate of 8 breaths/minute is dangerously low and indicates severe respiratory depression, requiring immediate intervention to prevent respiratory arrest.
Why the other options are wrong
- A. Drowsiness is a common side effect of morphine and, while needing monitoring, is not as immediately critical as severe respiratory depression.
- B. A decrease in pain from 8/10 to 4/10 indicates the medication is effective, which is an expected and desired outcome.
- C. Constipation is a common side effect of opioids but is not an immediate life-threatening concern 30 minutes after a single dose.
Opioid-Induced Respiratory Depression
A serious adverse effect of opioid analgesics characterized by a decreased rate and depth of breathing, which can lead to hypoxia and respiratory arrest.
- Common with opioids (e.g., morphine).
- Symptoms: low respiratory rate (<10-12/min), shallow breathing.
- Life-threatening complication.
- Requires immediate intervention (e.g., naloxone, respiratory support).
Memory trick: MORPHEUS: My Opioid Reaction Poses Huge Emergency, Unsafe Sleep!