A licensed vocational nurse (LVN) is working with a technician who says, "I wouldn't give that high dose of morphine if I were you
I once saw someone quit breathing with a dose that high." The LVN knows that the patient has been receiving the same dose for several days without any respiratory compromise. Which of the following responses by the LVN is best?
a. "As long as the dose is increased gradually, patients develop tolerance to the side effects of morphine."
b. "You are correct; several days of this high a dose could be cumulative and cause problems."
c. "As long as I monitor the patient closely after giving the dose, breathing will not be affected."
d. "I am a licensed professional and am able to decide what a safe dose is for my patient."
ANS: A
Morphine is an opioid agonist. Opioid doses can be escalated (titrated upward) indefinitely as needed as the patient's pain increases. As long as it is titrated slowly, tolerance to respiratory depression will develop. Monitoring may identify respiratory depression, but it will not prevent it. D blocks communication and does not take advantage of a teaching opportunity.
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