Morphine PDF

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ACTIVE LEARNING TEMPLATE:

Medication

brumsey STUDENT NAME shanena _____________________________________ MEDICATION morphine __________________________________________________________________________

REVIEW MODULE CHAPTER ___________

Agonists CATEGORY CLASS Opioid ______________________________________________________________________ PURPOSE OF MEDICATION

Expected Pharmacological Action - Mimics actions of naturally occurring opioids (endorphins, enkephalins) by binding with mu receptors causing analgesia, sedation, euphoria, respiratory depression

Therapeutic Use - Relief of moderate to severe pain Sedation -Reduction of bowel motility

Complications -Respiratory depression -Sedation, dizziness, lightheadedness, drowsiness -Constipation -Nausea, vomiting -Orthostatic hypotension -Urinary retention -Cough suppression -Potential for abuse -Tolerance with continued use and cross tolerance with other opioids

Medication Administration Administer orally, IM, IV, SC, rectally, or epidurally.

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 reserve; head injury; inflammatory bowel disease; prostatic enlargement; hypotension; hepatic or kidney disease

Interactions -CNS depressants (barbiturates, phenobarbital, benzodiazepines, alcohol) increase CNS depression -Anticholinergic agents, such as antihistamines, and tricyclic antidepressants increase anticholinergic effects (constipation, urinary retention) -MAOIs can cause hyperpyrexic coma (excitation, seizures, respiratory depression) with meperidine (Demerol) -Antihypertensives increase hypotensive effects

Evaluation of Medication Effectiveness - Relief of moderate to severe pain -Cough suppression -Resolution of diarrhea

ACTIVE LEARNING TEMPLATES

Nursing Interventions -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 urinary retention (bladder distention) -Encourage patients to urinate every 4 hr -Prepare to insert a urinary catheter to drain the bladder

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

THERAPEUTIC PROCEDURE

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