Adrianne Bazo October 21, 2008 Generic Name
Trade Hydrocodone/acetaminophen Name Lortab
Clinical Medications Worksheet Classification Dose Route opioid agonists/nonopioid analgesic combinations
7.5/550 1-2 tab
PO
Time/frequency Q 4˚ PRN
Peak
Onset
Duration
Normal dose range
30-60 min
10-30 min
4-6 hr
2.5-10 mg q 3-6 hr as needed; if using combination products, 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
Bind to opiate receptors in the CNS. Alter the perception of and response to painful stimuli while producing generalized CNS depression
Hypersensitivity, hypothyroidism
Common side effects confusion, sedation, hypotension, constipation
Moderate pain
Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) Lorazepam
Lab value alterations caused by medicine May cause increased plasma amylase and lipase concentrations
Be sure to teach the patient the following about this medication Advise patient to take medication exactly as directed and not to take more than the recommended amount. Severe and permanent liver damage may result from prolonged use or high doses of acetaminophen. Renal damage may occur with prolonged use of acetaminophen or aspirin. Doses of nonopioid agents should not exceed the maximum recommended daily dose Instruct patient on how and when to ask for pain medication May cause drowsiness or dizziness. Advise patient to call for assistance when ambulating Advise patient to change positions slowly to minimize orthostatic hypotension Encourage patient to turn, cough, and breathe deeply every 2 hr to prevent atelectasis 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 blood pressure, pulse, and respirations before and periodically during administration. Assess type, location, and intensity of pain prior to and 1 hr (peak) following administration.
Assessment
Why would you hold or not give this med?
Before administering, clarify all ambiguous orders; have second practitioner independently check original order and dose calculations, If respiratory rate is <10/min, assess level of sedation. Physical stimulation may be sufficient to prevent significant hypoventilation. Reports no pain
Evaluation Check after giving Decrease in severity of pain without a significant alteration in level of consciousness or respiratory status