Morphine (astramorph) Pca

Generic Name Morphine Peak 20 min

NURS 1566 Clinical Form 3: Clinical Medications Worksheets Trade Name Classification Dose Route Time/frequency opioid analgesics Astramorph 20 mg IV, PCA Q 3-4 hr 2mg/10min Onset Duration Normal dosage range Rapid 4-5 hr 2-4mg/24hr; may ↑ by 1-2mg/day(up to 30mg/day)

Why is your patient getting this medication Sever pain

For IV meds, compatibility with IV drips and/or solutions Rate: administer via infusion pump to control the rate. Dose should be titrated to ensure adequate pain relief /s excessive sedation, respiratory depression, or hypotension.

Mechanism of action and indications (Why med ordered)

Nursing Implications (what to focus on) Contraindications/warnings/interactions

Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression

Hypersensitivity, Some products contain tartrazine, bisulfites, or alcohol and should be avoided in patients with known hypersensitivity. hypothyroidism Regularly administered doses may be more effective than prn administration. Analgesic is more effective if given before pain becomes severe. Morphine should be discontinued gradually to prevent withdrawal symptoms after long-term use

Common side effects confusion, sedation, hypotension, constipation

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) None for this patient

Lab value alterations caused by medicine May ↑ plasma amylase and lipase levels

Be sure to teach the patient the following about this medication Instruct patient how and when to ask for pain medication. May cause drowsiness or dizziness. Caution patient to call for assistance when ambulating. Advise patient tEncourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent atelectasiso change positions slowly to minimize orthostatic hypotension.

Nursing Process- Assessment (Pre-administration assessment) Assess type, location, and intensity of pain prior to and 20 min (peak) following IV administration. Assess bowel function routinely. Ask about breakthrough pain

Assessment Why would you hold or not give this med? Assess level of consciousness, 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. Subsequent doses may need to be decreased by 25-50%. Initial drowsiness will diminish with continued. Toxicity and Overdose: If an opioid antagonist is required to reverse respiratory depression or coma, naloxone (Narcan) is the antidote.

Evaluation Check after giving Decrease in severity of pain without a significant alteration in level of consciousness or respiratory status.