NURS 1566 Clinical Form 3: Clinical Medications Worksheets

Generic Name Trade Name Classification Dose Route Time/frequency

Morphine Astramorph opioid analgesics 20 mg IV, PCA Q 3-4 hr
2mg/10min
Peak Onset Duration Normal dosage range
20 min Rapid 4-5 hr 2-4mg/24hr; may ↑ by 1-2mg/day(up to 30mg/day)

Why is your patient getting this medication For IV meds, compatibility with IV drips and/or
Sever pain solutions
Rate: administer via infusion pump to control the rate.
Dose should be titrated to ensure adequate pain relief /s
excessive sedation, respiratory depression, or hypotension.

Mechanism of action and indications Nursing Implications (what to focus on)

(Why med ordered)
Binds to opiate receptors in the CNS. Alters the perception of
and response to painful stimuli while producing generalized
CNS depression
Contraindications/warnings/interactions
Hypersensitivity, Some products contain tartrazine, bisulfites, or
alcohol and should be avoided in patients with known hypersensitivity.
hypothyroidism
Regularly administered doses may be more effective than prn
administration. Analgesic is more effective if given before pain
becomes severe. Morphine should be discontinued gradually to prevent
withdrawal symptoms after long-term use
Common side effects
confusion, sedation, hypotension, constipation

Interactions with other patient drugs, OTC or
herbal medicines (ask patient specifically)
None for this patient
Nursing Process- Assessment
(Pre-administration assessment)
Assess type, location, and intensity of pain prior to
and 20 min (peak) following IV administration.
Assess bowel function routinely. Ask about
breakthrough pain
Lab value alterations caused by medicine
May ↑ plasma amylase and lipase levels
Be sure to teach the patient the following about this
medication
Instruct patient how and when to ask for pain medication. May cause
drowsiness or dizziness. Caution patient to call for assistance when
ambulating. Advise patient tEncourage patients who are immobilized
or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr
to prevent atelectasiso change positions slowly to minimize orthostatic
hypotension.
Assessment Evaluation
Why would you hold or not give this Check after giving
med? Decrease in severity of pain
Assess level of consciousness, blood pressure, without a significant alteration in
pulse, and respirations before and periodically level of consciousness or
during administration. If respiratory rate is respiratory status.
<10/min, assess level of sedation. Physical
stimulation may be sufficient to prevent
significant hypoventilation. Subsequent doses
may need to be decreased by 25-50%. Initial
drowsiness will diminish with continued.
Toxicity and Overdose: If an opioid
antagonist is required to reverse respiratory
depression or coma, naloxone (Narcan) is the
antidote.