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The client with the morphine epidural infusion is at highest risk for respiratory depression and should be assessed first

For cohort studies, we utilized the Newcastle-Ottawa Quality Assessment Scale for quantitative analysis, the Newcastle-Ottawa Scale was developed to assess the quality of nonrandomized studies with its design, content and ease of use directed to the task of incorporating the quality assessments in the interpretation of meta-analytic results (20)

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Smoking interferes with brain circuitry that is associated with pain