A nurse is reviewing a client’s medical history before administering a new prescription for atropine. Which of the following client conditions is contraindicated?

A. Vomiting 30 mL of fluid. This finding is not the priority because while vomiting can be a side effect of morphine, it is not immediately life-threatening.
B. Blood pressure 90/60 mm Hg. This finding is concerning but not the priority. Morphine can cause hypotension, but the primary concern with morphine administration is respiratory depression.
C. Respirations deep at a rate of 10/min. This finding is the priority because morphine can cause respiratory depression, which can be life-threatening. Monitoring and addressing respiratory status is critical when administering opioids.
D. Urinary output of 20 mL within 1 hr. This finding is concerning but not the priority. Low urinary output can indicate dehydration or renal issues, but respiratory depression is the most immediate concern with morphine administration.

A. Use the Z-track method to administer the medication is typically used for intramuscular injections to prevent medication from leaking back into the subcutaneous tissue. It is not appropriate for subcutaneous heparin injections and does not help minimize bleeding.
B. Grasp skin between thumb and forefinger throughout the injection helps to stabilize the tissue and ensure the medication is delivered into the subcutaneous layer. This technique can help minimize bleeding and bruising by reducing tissue trauma during the injection.
C. Gently massage the site following the injection is not recommended for heparin injections as it can increase the risk of bleeding and bruising. Massaging the site can cause the medication to spread into the surrounding tissue, leading to hematoma formation.
D. Aspirate the syringe prior to injecting the heparin is not necessary for subcutaneous injections and can increase the risk of bleeding. Aspiration is typically done for intramuscular injections to ensure the needle is not in a blood vessel, but it is not required for subcutaneous heparin administration.