NURS 2516 Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name propoxyphene napsylate/acetaminophen
Trade Name
Classification opioid analgesics
Dose 100 mg
Route PO
Time/frequency q 4 hours PRN
Darvocet-N
Peak
Onset
Duration
Normal dose range:
2-3 hr
15-60 min
4-6 hr
100 mg q 4 hr
acetaminophen or aspirin dosage should not exceed 4 g/day
Mechanism of action and indications (Why med ordered)
Nursing Implications (what to focus on) Contraindications/warnings/interactions
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
Hypersensitivity, Hypothyroidism,
Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)
Lab value alterations caused by medicine
↑ CNS depression with antidepressants , and sedative/hypnotics, Smoking ↑ metabolism and may decrease analgesic effectiveness, Nalbuphine , buprenorphine , or pentazocine may ↓ analgesia
Common side effects dizziness, weakness, nausea
May cause ↑ serum amylase and lipase levels, May cause ↑ 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
Nursing Process- Assessment (Pre-administration assessment) Assess type, location, and intensity of pain prior to and 2 hr (peak) following administration. 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
Assessment Why would you hold or not give this med? Assess blood pressure, pulse, and respirations before and periodically during administration. If respiratory rate is <10/min, assess level of sedation. 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
Evaluation Check after giving Decrease in severity of pain without a significant alteration in level of consciousness