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ATI Morphine - ATI

Medical Surgical Nursing I (Ivy Tech Community College of Indiana)

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ACTIVE LEARNING TEMPLATE: Medication

Rachel Garcia
STUDENT NAME _____________________________________
morphine- What to teach regarding IV morphine?
MEDICATION __________________________________________________________________________ 36 in ATI
REVIEW MODULE CHAPTER ___________
Opioid Agonists
CATEGORY CLASS ______________________________________________________________________

PURPOSE OF MEDICATION

Expected Pharmacological Action Therapeutic Use

- Mimics actions of naturally occurring opioids - Relief of moderate to severe pain
(endorphins, enkephalins) by - Sedation
binding with mu receptors causing analgesia, sedation, -Reduction of bowel motility
euphoria, respiratory depression (ATI, p. 285) -Cough suppression (codeine) (ATI, p. 285)

Complications Medication Administration

-Respiratory depression -Measure baseline vital signs before administration and
-Sedation, dizziness, lightheadedness, drowsiness monitor throughout therapy.
-Constipation
-Nausea, vomiting
-Administer orally, IM, IV, SC, rectally, or epidurally.
-Orthostatic hypotension -Make sure patients swallow sustained-release forms
-Urinary retention whole and do not crush or chew them.
-Cough suppression -Administer IV opioids by diluting as recommended and
-Potential for abuse administering slowly over 4 to 5 min; have naloxone and
-Tolerance with continued use and cross tolerance with other opioids (ATI, p. 285)
resuscitation equipment available.
-Monitor PCA (patient-controlled analgesic pump) use and
pump settings carefully.
-Administer to patients with cancer on a fixed,
around-the-clock dosing schedule, not PRN. (ATI, p.
286-287)
Contraindications/Precautions
-Contraindications: Pregnancy risk category D (long-term use, high doses, near term;
otherwise C); kidney failure; increased intracranial pressure; biliary colic; biliary tract
surgery; preterm labor
- Precautions: Schedule II controlled substance; older adults, infants; reduced respiratory Nursing Interventions
reserve; head injury; inflammatory bowel disease; prostatic enlargement; hypotension;
hepatic or kidney disease (ATI, p. 286) -Monitor vital signs and auscultate lungs
-For respiratory rates below 12 per min, withhold the
drug, stimulate breathing, and administer an opioid
antagonist if indicated; naloxone to restore respiratory
rate
-Monitor patients when ambulating to prevent injury
-Encourage fiber supplements, stool softeners
-Monitor intake and output, watching for signs of
Interactions urinary retention (bladder distention)
-Encourage patients to urinate every 4 hr
-CNS depressants (barbiturates, phenobarbital, benzodiazepines, alcohol) increase CNS depression -Prepare to insert a urinary catheter to drain the
-Anticholinergic agents, such as antihistamines, and tricyclic antidepressants increase anticholinergic bladder (ATI, p. 286-287)
effects (constipation, urinary retention)
-MAOIs can cause hyperpyrexic coma (excitation, seizures, respiratory depression) with meperidine
(Demerol)
-Antihypertensives increase hypotensive effects
-St. John’s wort can increase sedation (ATI, p. 286)

Client Education
-Take the drug only when needed and short-term
-Do not take prior to driving or activities requiring
mental alertness
Evaluation of Medication Effectiveness -Sit or lie down if feeling lightheaded
-Change positions gradually
-Increase fluid and fiber intake; activity and exercise
- Relief of moderate to severe pain -Take the drug with food or milk (oral forms)
-Cough suppression -Sit or lie down if feeling lightheaded.
-Rise slowly from a reclining or sitting position
-Resolution of diarrhea (ATI, p. 287) -Report any inability to urinate or difficulty urinating
-Cough regularly to clear secretions from the throat
and chest (ATI, p. 286-287)

ACTIVE LEARNING TEMPLATES Downloaded by Tommie Waiters (twaiters2554@student.egcc.edu) THERAPEUTIC PROCEDURE A7