A nurse is preparing to administer morphine sulfate 2 mg IV bolus. Available is morphine sulfate 10 mg/mL How many mL should the nurse administer per dose?

(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Rationale:

A) Administer ibuprofen as needed for pain: Ibuprofen is not typically recommended for pain relief in infants under 6 months old due to the risk of adverse effects, such as gastrointestinal irritation and renal impairment. Additionally, surgical repair of a cleft lip is not typically associated with severe postoperative pain requiring ibuprofen in infants.

B) Encourage the parents to rock the infant: This is the correct intervention. Rocking or gentle movement can provide comfort to infants postoperatively and may help soothe them. It can also promote bonding between the infant and parents, which is important for emotional support during the recovery period.

C) Offer the infant a pacifier: Pacifiers can be soothing for infants and may help provide non-nutritive sucking comfort. However, it's essential to ensure that the pacifier does not interfere with wound healing or exacerbate discomfort related to the cleft lip repair. Therefore, while offering a pacifier may be appropriate, it should be done with caution and under the guidance of the surgical team.

D) Position the infant on her abdomen: Placing the infant on her abdomen (prone position) is not recommended postoperatively, especially after cleft lip repair surgery. The supine position is typically preferred to reduce the risk of aspiration and ensure adequate airway patency. Additionally, the prone position may put pressure on the surgical site and cause discomfort.

A. "The oral medication you will take after this IV will dissolve the clot": This statement is incorrect. While anticoagulants like warfarin or direct oral anticoagulants (DOACs) may be prescribed to prevent the formation of new clots or to treat existing clots, heparin, whether administered intravenously or subcutaneously, is not typically used to dissolve existing clots.
B. "A pharmacist is the person to answer that question": This response deflects the client's question and does not provide useful information. While pharmacists are knowledgeable about medications, nurses are responsible for educating clients about their treatments and should be able to provide accurate information regarding heparin therapy.
C. "Heparin does not dissolve clots. It stops new clots from forming": This is the correct response. Heparin is an anticoagulant medication that works by inhibiting the formation of new clots rather than dissolving existing ones. It does so by inhibiting the activity of clotting factors in the blood, thus preventing the clot from enlarging or new clots from forming.
D. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level": While this statement provides information about the time required for heparin to achieve a therapeutic effect, it does not address the client's specific question about clot dissolution. Heparin's anticoagulant effects occur rapidly, but its primary action is prevention rather than dissolution of existing clots.