A client is prescribed morphine after back surgery. Which conditions would be a contraindication for the administration of morphine? (Select all that apply.)
a. Perforated duodenum secondary to ulcer disease
b. Closed-head injury of a trauma victim
c. Respiratory distress secondary to long-standing COPD
d. Septic shock with no urine output
e. Hypertension
b. Closed-head injury of a trauma victim
c. Respiratory distress secondary to long-standing COPD
d. Septic shock with no urine output
FEEDBACK:
a. Perforated duodenum secondary to ulcer disease would not be a contraindication for pain management.
b. Closed-head injury of a trauma victim is a contraindication because narcotics decrease the respiratory rate leading to decreased respirations, hypoxia, increased CO2 level, increased vasodilation of cerebral blood vessels and increased intracranial pressure. .
c. Respiratory distress secondary to long-standing COPD is contraindicated because the narcotics decrease the respiratory rate and drive. .
d. Septic shock causes massive vasodilation throughout the body to compensate for poor tissue perfusion. Adding a narcotic would exaggerate this process and could lead to death. .
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