A patient is admitted to the hospital with an INR of 3.9, history of GI bleeding, and osteomyelitis. The patient is complaining of bone pain so the nurse prepares to administer morphine. Which route should be avoided?


• With an elevated INR of 3.9, the patient is at risk for bleeding. 

• Muscles are highly vascular, and due to the patient's high INR, this intramuscular (IM) route should be avoided due to the risk of bleeding and hematoma formation.

• Another method of administration (PO, IV, subcutaneous injection) would be used for this patient. Morphine is available in a wide variety of forms for administration to include liquid, tablets, extended-release capsules,injections, and suppositories.

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