A patient is admitted to the burn unit with 75 body surface area ...

[P68T]

A patient is admitted to the burn unit with 75 body surface area burns. Which orders would be appropriate for this patient 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.

Question 2

The nurse is preparing an intramuscular (IM) injection for a patient with strep throat. What principles of absorption may have guided the health care provider's decision to order the medication by IM route?
 
  1. IM drugs are rapidly absorbed.
  2. IM drugs bypass the gastrointestinal tract, resulting in increased absorption.
  3. IM drugs avoid drug?drug and food?drug interactions, which can decrease absorption.
  4. IM drugs have the ability to accumulate in the muscle and may remain in the body for an extended amount of time.
  5. IM drugs bypass the gastrointestinal tract and are delivered to the small intestine, where most medications are rapidly absorbed.

[rleezy04]

Answer to Question 1

Correct Answer: 1,4
Rationale 1: Pain medication given by the intravenous (IV) route will be rapidly and completely absorbed.
Rationale 2: The patient has 75 surface area burns; there may not be an area available for intramuscular injections of morphine.
Rationale 3: The patient 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 patient has 75 surface area burns; there may not be an area available for subcutaneous injections.

Answer to Question 2

Correct Answer: 1,2,3
Rationale 1: Muscles have a high blood flow, which maximizes absorption.
Rationale 2: The thick mucous layer of the stomach decreases absorption. IM drugs bypass this obstacle, resulting in increased absorption.
Rationale 3: Oral medications and food can interfere with absorption of medications. Bypassing the gastrointestinal tract will remove this possibility.
Rationale 4: Some tissues do have the ability to accumulate and store drugs. Muscle tissue is not one of these. The bone marrow, teeth, eyes, and adipose tissue have an affinity to store drugs.
Rationale 5: IM drugs do bypass the gastrointestinal tract but are not exposed to the small intestine. IM drugs are absorbed from the muscle into the blood stream.

[P68T]

Excellent

[essyface1]

TYSM