NURS 1566 Clinical Form 3: Clinical Medications Worksheets
Generic Name Trade Name Classification
Nalbuphine Nubain Opioid analgesics 2mg
Peak Onset Duration Normal dosage range
30 min 2-3 min 3-6 hr 0.3-3mg/kg over 10-15 min
Why is your patient getting this medication
Pain r/t knee surgery
Mechanism of action and indications
(Why med ordered)
Binds to opiate receptors in the CNS, alters the
perception of and responses to painful stimuli
while producing generalized CNS depression
Interactions with other patient drugs, OTC or
herbal medicines (ask patient specifically)
Nursing Process- Assessment
(Pre-administration assessment)
Assess type, location, and intensity of pain
before and 1 hr after IM or 30 min (peak) after
IV administration. When titrating opioid
doses, increases of 25-50% should be
administered until there is either a 50%
reduction in the patient's pain rating on a
numeric or visual analogue scale or the patient
reports satisfactory pain relief. A repeat dose
can be safely administered at the time of the
peak if previous dose is ineffective and side
effects are minimal. Patients requiring doses
higher than 20 mg should be converted to an
opioid agonist.
Assess blood pressure, pulse, and
respirations before and periodically during
administration. If respiratory rate is
<10/min, assess level of sedation.
Physical stimulation may be sufficient to
prevent significant hypoventilation. Dose
may need to be decreased by 25-50%.
Dose Route Time/frequency
IVP PRN
For IV meds, compatibility with IV drips and/or
solutions
Y-Site Incompatibility: ♦cefepime ♦methotrexate ♦nafcillin
♦piperacillin/tazobactam ♦ sargramostim ♦sodium bicarbonate
Nursing Implications (what to focus on)
Contraindications/warnings/interactions
Hypersensitivity, hypothyroidism,
Common side effects
Dizziness, headache, sedation, dry mouth, nausea,
vomiting, clammy feeling, sweating
Lab value alterations caused by medicine
May cause increased serum amylase and lipase concentrations
Be sure to teach the patient the following about this
medication
May cause drowsiness or dizziness. Advise patient to call for
assistance when ambulating and to avoid driving or other activities
requiring alertness until response to the medication is known. Caution
patient to change positions slowly to minimize orthostatic hypotension.
Advise patient that frequent mouth rinses, good oral hygiene, and
sugarless gum or candy may decrease dry mouth. Encourage patient to
turn, cough, and breathe deeply every 2 hr to prevent atelectasis
Assessment Evaluation
Why would you hold or not give this Check after giving
med? Decrease in severity of pain
Toxicity and Overdose: If an opioid without significant alteration in
antagonist is required to reverse respiratory level of consciousness or
depression or coma, naloxone (Narcan) is the respiratory status
antidote.