A patient was admitted to the ER diagnosed with MI unrelieved by nitrates. The physician orders morphine IV push. Which of the following assessments is a priority nursing action?
  1. Check the patient’s blood pressure
  2. Perform the Glasgow coma scale
  3. Check rate of IV infusion
  4. Auscultate breath sounds
Explanation
Answer- A - The priority nursing action is to check the blood pressure of the patient. The nurse must check the blood pressure before administering morphine. The nurse should be able to check the vital signs but must put emphasis on checking the blood pressure especially when the physician orders morphine. Before administration of this medication, BP is checked to have a baseline data and to prevent hypotension.
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