Certified Registered Nurse Infusion (CRNI) Practice Exam

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For spinal infusions, what is the recommended dosage of preservative-free morphine?

1/5 the epidural dose
1/10 the epidural dose
Equal to the epidural dose
2 times the epidural dose

The correct answer is: 1/10 the epidural dose

The recommended dosage of preservative-free morphine for spinal infusions is indeed 1/10 the epidural dose. This guideline is rooted in the differences in pharmacokinetics and dynamics between spinal and epidural administration. Spinal infusions deliver medication directly to the cerebrospinal fluid (CSF), allowing for a more concentrated effect and a quicker response. This route bypasses many barriers that medications encounter when administered via the epidural space. Because of this enhanced potency, it is crucial to administer a much smaller dose compared to the epidural dose, hence the recommendation to use 1/10 of that dose. This approach helps prevent the risk of respiratory depression and other potential side effects associated with higher doses of morphine when delivered directly into the spinal fluid. The other dosage options would provide an excessive amount of medication, which could lead to complications, underlining the importance of adhering to recommended dosing guidelines for spinal infusions.