A client is admitted to the burn unit with 75% body surface area burns. Which orders would be appropriate for this client to control pain?
1. Morphine 10 mg IV every 2 to 4 hours as needed for pain
2. Morphine 10 mg IM every 2 to 4 hours as needed for pain
3. Morphine 10 mg transdermal patch every 2 to 4 hours as needed for pain
4. Morphine 10 mg sublingual every 2 to 4 hours as needed for pain
5. Morphine 10 mg subcutaneous every 2 to 4 hours as need for pain
Correct Answer: 1,4
Rationale 1: Pain medication given by the intravenous (IV) route will be rapidly and completely absorbed.
Rationale 2: The client has 75% surface area burns; there may not be an area available for intramuscular injections of morphine.
Rationale 3: The client has 75% surface area burns; there may not be an area available to place a transdermal patch.
Rationale 4: Sublingual morphine can be used as a rescue drug.
Rationale 5: The client has 75% surface area burns; there may not be an area available for subcutaneous injections.
Global Rationale: Pain medication given by the intravenous (IV) route or sublingually will be rapidly and completely absorbed. The client has 75% surface area burns; there may not be an area available for intramuscular, transdermal, or subcutaneous injections of morphine.
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