One hour after receiving IV morphine sulfate, a patient reports itching. The patient has clear breath sounds, no rash, respirations of 18 breaths per minute, a heart rate of 71 bpm, and a BP of 110/70 mm Hg. Which action should the nurse take?

Choice A rationale Naloxone is an opioid antagonist used to reverse the effects of opioid overdose, characterized by severe central nervous system depression, particularly respiratory depression (e.g., respirations <10 breaths/min). The patient's vital signs are stable and within normal range (Respirations 18/min, HR 71 bpm, BP 110/70 mm Hg), and itching alone does not indicate an overdose requiring reversal. Choice B rationale The patient's vital signs (Respirations 18/min, HR 71 bpm, BP 110/70 mm Hg) and clinical presentation (clear breath sounds, no rash) are stable. Itching (pruritus) is a common, non-life-threatening side effect of morphine sulfate due to histamine release, not a sign of impending respiratory or cardiovascular collapse. Therefore, preparing resuscitation equipment is an unnecessary, excessive intervention. Choice C rationale Anaphylactic reactions are a true drug allergy and are characterized by life-threatening systemic symptoms like urticaria, angioedema, wheezing, bronchospasm, and hypotension. The patient only reports isolated itching (pruritus) with stable vital signs and clear breath sounds, indicating a common, benign, histamine-release reaction, not an IgE-mediated anaphylactic emergency requiring epinephrine. Choice D rationale Pruritus (itching) is a very common side effect of opioid administration, including morphine, resulting from a generalized histamine release from mast cells that is unrelated to a true allergic reaction. Since the patient exhibits stable vital signs and no other signs of anaphylaxis (e.g., rash, wheezing), the appropriate action is to reassure the patient and perhaps offer a non-pharmacological comfort measure or an antihistamine, if ordered.