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Welcome to drbubsโ€™s page.
Contributor score: 9


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 +4  visit this page (step2ck_form7#25)
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  1. As other comments pointed out, since she has metastatic breast cancer she likely has a poor prognosis and pain management becomes the most important aspect of her care.

  2. 1mg SubQ morphine q3h is less morphine than she is receiving currently with 5mg morphine q4h PO.

Morphine equivalents for PO:IV morphine is 3:1. Let's assume IV and subQ are equivalent so the ratio remains 3:1. (Idk if they are or not, but IV would definitely be the most potent)

5mg PO morphine q4h = 30mg daily orally. So you would need 10mg daily either IV or subQ to match her current pain regimen.

1mg subQ morphine q3h = 8mg daily via subQ.

Thus, **the only answer choice that increases her morphine dose is increasing the frequency of her PO dosign to q3h.

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charcot_bouchard  SMOOTH Bro... +




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submitted by thomasalterman(181), visit this page
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my reasoning:

  • diuretics cause hypokalemia โ†’
  • hypokalemia causes โ†‘ digoxin binding to Na/K ATPase โ†’ cardiac dysfunction (i.e. PVCs)
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seagull  They don't specify the exact diuretic. More cause hyperkalemia than not. Also, digoxin causes hyperkalemia (mild). This questions answer is infact opposite to what is a logical conclusion. +5
drbubs  Most diuretics would lead to hypokalemia. Inhibiting the loop of henle or DCT (loop diuretics and thiazides) causes increased Na to reach to the collecting tubules where aldosterone-dependent transporters reabsorb Na at the expense of potassium leading to hypokalemia. It is why we call diuretics that act on the collecting tubules "potassium-sparing" diuretics. +5


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