Before initiating a PCA pump with morphine, what is the highest priority assessment the nurse should perform?

The highest priority assessment before initiating a PCA (Patient-Controlled Analgesia) pump with morphine is to evaluate the rate and depth of the client's respirations. This is crucial because morphine is an opioid analgesic that can significantly depress respiratory function, especially in individuals who may be opioid-naive or have underlying respiratory issues. By assessing the client's respiratory status, the nurse can identify any risk of respiratory depression, which is a potentially life-threatening side effect of opioid medication.

While checking the expiration date of the morphine syringe is important for medication safety, it does not have an immediate impact on patient safety in the context of opioid administration. Similarly, understanding the type of anesthesia used during the surgical procedure can provide context regarding pain management but does not directly influence the immediate assessment for safe opioid administration. Assessing the client's pain is also important for effective pain management, but it is secondary to ensuring that the patient's respiratory function is stable enough to safely proceed with PCA morphine, as respiratory depression could lead to severe complications. Therefore, prioritizing respiratory assessment ensures that the client can tolerate the opioid safely.