Clinical Medications Worksheets

Generic Name Morphine Sulphate Peak 20 min Trade Name PMS- morphine Onset rapid Classification Opioid analgesic Duration 4-5 hrs Dose 1mg/ml Route IV (PCA) Time/frequency PRN Pain

Why is your patient getting this medication Pain

Mechanism of action and indications (Why med ordered) Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) Additive CNS depression with Tylenol3, Loratab, Ativan,, phenytoin

Normal dosage range Usual starting dose for moderate to severe pain in opioidnaive patients--4-10 mg q 3-4 hr. Rate: Administer 2.5-15 mg over 4-5 min. Rapid administration may lead to increased respiratory depression, hypotension, and circulatory collapse For IV meds, compatibility with IV drips and/or solutions Solution is colorless; do not administer discolored solution. Dilute with at least 5 ml of sterile water or 0.9% NaCl for injection to a concentration of 0.5-5 mg/ml Y-Site Incompatibility: amphotericin B cholesteryl sulfate, azithromycin, cefepime, doxorubicin liposome, minocycline, phenytoin, sargramostim Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity, Some products contain tartrazine, bisulfites, or alcohol and should be avoided in patients with known hypersensitivity Common side effects confusion, sedation, RESPIRATORY DEPRESSION, hypotension, constipation Lab value alterations caused by medicine May plasma amylase and lipase levels

Nursing Process- Assessment (Pre-administration assessment) Assess type, location, and intensity of pain prior to and 20 min (peak) following IV administration. Assess level of consciousness, blood pressure, pulse, and respirations before and periodically during administration. Assess bowel function routinely.

Be sure to teach the patient the following about this medication Instruct pt on when and how to ask for pain medication and how to rate pain on a scale of one to ten. Advise to change positions slowly to minimize orthostatic hypotension. Encourage pt to turn cough and deep breathe to prevent atelectasis. Assessment Evaluation Why would you hold or not give this med? Check after giving If respiratory rate is <10/min, assess level of Decrease in severity of sedation. Toxicity (administer Narcan) pain without a significant alteration in level of consciousness or respiratory status