A patient with myocardial infarction is treated with intravenous morphine sulfate for chest pain. Which of the following actions by the nurse has the highest priority when administering this medication?
1. assess for medication infiltration into tissues
2. determine the patient's sedation level
3. check breath sounds every 15 minutes
4. observe for signs of opioid addiction
2
Rationale: Extreme sedation typically precedes respiratory depression; therefore, it is important to monitor the patient who receives opioid substances for oversedation. Drug infiltration into tissues is an important assessment for any intravenous therapy; however, early detection of symptoms that precede respiratory depression has a higher priority. It is not necessary to assess breath sounds at frequent intervals when pulmonary pathology is not an immediate concern. Acute pain requires treatment and typically does not result in narcotic addiction.
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