What to do first
1. Assess pain, respiratory rate, oxygen saturation, sedation level, and blood pressure before giving.
2. Reassess pain and respiratory status after administration per protocol.
3. Use fall precautions and monitor constipation risk.
Morphine Nursing Considerations NCLEX Priority Sheet
Morphine questions test pain reassessment, respiratory depression, sedation, blood pressure, constipation, fall risk, and naloxone as the reversal agent when ordered.
Study aid - not medical advice. Not a clinical decision tool. For NCLEX pharmacology review only.
Hold If
Notify the provider and hold per protocol for RR <12/min, severe sedation, difficult arousal, hypotension, oxygen desaturation, new confusion, or suspected overdose.
Naloxone is the opioid antagonist, but give only as ordered or per emergency protocol.
Labs to Watch
Morphine safety is driven by assessment: RR, SpO2, BP, sedation score, pain score, bowel function, and urine output.
Renal and hepatic function may affect opioid handling. ABGs may be ordered if respiratory status worsens.
Review Details
NCLEX Review Notes
Key Adverse Effects
High priority: respiratory depression and severe sedation.
Common: constipation, nausea/vomiting, pruritus, urinary retention, orthostatic hypotension, and fall risk.
Common: constipation, nausea/vomiting, pruritus, urinary retention, orthostatic hypotension, and fall risk.
NCLEX Trap
Trap: reassess only pain after giving morphine.
Safer answer: reassess pain and respiratory/sedation status. Analgesia is expected, but breathing and arousability are the safety priority.
Safer answer: reassess pain and respiratory/sedation status. Analgesia is expected, but breathing and arousability are the safety priority.
Related Pattern
Morphine vs NSAIDs: morphine does not directly increase bleeding the way NSAIDs can, but it can cause respiratory depression and constipation.
Opioid class: naloxone reverses opioid effects as ordered or per protocol.
Opioid class: naloxone reverses opioid effects as ordered or per protocol.
Mini Quiz
Question: A patient requests morphine, but RR is 9/min and the patient falls asleep mid-sentence. What should the nurse do?
Answer: hold per protocol, assess airway/breathing and sedation, notify the provider, and anticipate ordered opioid reversal or supportive care if needed.
Answer: hold per protocol, assess airway/breathing and sedation, notify the provider, and anticipate ordered opioid reversal or supportive care if needed.
References
Saunders Comprehensive Review for the NCLEX-RN Examination; Davis's Drug Guide for Nurses; DailyMed morphine sulfate labeling; DailyMed naloxone hydrochloride labeling.