Which intervention is appropriate for the nurse caring for a male client in severe pain receiving a continuous I.V. infusion of morphine?
A. Discontinuing the drug immediately if signs of dependence appear
B. Assisting with a naloxone challenge test before therapy begins
C. Obtaining baseline vital signs before administering the first dose
D. Changing the administration route to P.O. if the client can tolerate fluids
Correct Answer: C. Obtaining baseline vital signs before administering the first dose
Option C: The nurse should obtain the client’s baseline blood pressure and pulse and respiratory rates before administering the initial dose and then continue to monitor vital signs throughout therapy.
Option A: The nurse shouldn’t discontinue a narcotic agonist abruptly because withdrawal symptoms may occur.
Option B: A naloxone challenge test may be administered before using a narcotic antagonist, not a narcotic agonist.
Option D: Morphine commonly is used as a continuous infusion in clients with severe pain regardless of the ability to tolerate fluids.
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