Darvocet N Drug Card

NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name propoxyphene napsylate/ acetaminophen Peak 2-3 hr

Trade Name Darvocet-N

Classification opioid analgesics

Onset 15-60 min

Dose 100 mg

Duration 4-6 hr

Route PO

Time/frequency Q 4 hours PRN

Normal dosage range 50-100 mg

Why is your patient getting this medication Pain with rt. Hip fracture

For IV meds, compatibility with IV drips and/or solutions

Mechanism of action and indications (Why med ordered) Mild to moderate pain, Binds to opiate receptors in the CNS Alters the perception of and response to painful stimuli, while producing, generalized CNS depression

Nursing Implications (what to focus on) Contraindications/warnings/interactions Appears on Beers list. Elderly or debilitated patients require reduced dosages, Undiagnosed abdominal pain, Hypothyroidism,

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) Other opioid analgesics and sedative/hypnotics

Nursing Process- Assessment (Pre-administration assessment) Assess type, location, and intensity of pain prior to and 2 hr following admin. Assess bowel function routinely. Prevention of constipation should be instituted with increased intake of fluids and bulk, and laxatives to minimize constipating effects. Stimulant laxatives should be administered routinely if opioid use exceeds 2-3 days, unless contraindicated. monitor closely and assess falls risk

Common side effects dizziness, weakness, nausea

Lab value alterations caused by medicine May cause increase in serum amylase and lipase levels, May cause increase in AST, ALT, serum alkaline phosphatase, LDH, and bilirubin Be sure to teach the patient the following about this medication Instruct patient on how and when to ask for pain medication Encourage patient to turn, cough, and breathe deeply every 2 hr to prevent atelectasis, Advise patient to change positions slowly to minimize ,orthostatic hypotension, Advise patient that good oral hygiene, frequent mouth rinses, and sugarless gum or candy may decrease dry mouth Assessment Evaluation Why would you hold or not give this med? Check after giving Assess blood pressure, pulse, and Decrease in severity of pain respirations before and periodically without a significant during administration. If respiratory rate alteration in level of is <10/min, assess level of sedation. consciousness Physical stimulation may be sufficient to prevent significant hypoventilation. Dose may need to be decreased by 25-50%. Initial drowsiness will diminish with continued use