A patient is admitted to the hospital with an INR of 3.9, history of a GI bleed, 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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