• Rasmussen College

• NUR 2407

NEGATIVELY WORDED 3 | SATA 4 | Morphine 4 | PCA 1 | Antihistamines 3 |Acetaminophen 3 | Glucocorticoids 2 | Dose Calc 2

MORPHINE – reduces pain without affecting other senses: touch, smell, sight, and hearing. Reduces pain without causing loss of consciousness (IM, IV, SubQ, oral,

epidural)

Effects: Cough suppression, treatment for diarrhea, and pain control

Education:

· Avoid alcohol and other CNS depressants

· Do not drive

· Change positions slowly

Nurse Education:

• Monitor your patient for tolerance; may need higher dose to achieve same effects for chronic pain

• Physical Dependence: rare when used correctly and for acute pain (not the same as addiction)

• Addiction risk: rare when used correctly

• Resp. are more important than BP and HR to monitor

• (rep. depression can last 4-5 hr. for IV, IM, subQ)

w Abuse – Schedule II

w Hydromorophone – 7x stronger

w Fentanyl – Highly concentrated

w OxyContin and MS Contin – DO NOT CRUSH

**ALL opioids can be reversed by the opioid antagonist: naloxone (Narcan) Blocks the effects of opioid agonists at opioid receptor sites

PCA –may contain Morphine or hydromorphone - only the patient and nurse should push button for dosing

• Self-administered (transdermal, IV, SubQ, epidural) on an “as needed” basis

• Some administer a basal infusion only

• Some are bolus only

• Some are both

• “Lock-out” periods help prevent overdose

• No one, except patient and nurse, should be touching the PCA