opioid/narcotic type Flashcards
what are opioids not meant to do?
they are not nsaids
Opioids will not reduce a fever
are not anti-inflammatory
not good for gout or rheumatoid arthritis.
Morphine
hold if respirations are below 10 will causes respiratory depression
Hydromorphone
aka?
reduce respirations
decrease blood pressure=hypotension
orthostatic hypotention
dilaudid
Codeine
used as cough suppressant
Meperidine
aka
Demerol
DO NOT GIVE TO PATIENTS WITH INCREASED INTRACRNAIL PRESSURE OR SICKLE CELL ANEMIA
OXYCODONE
Percocet
HAS ASPIRIN IN IT DO NOT GIVE IF PATIENT IS ALLERGIC
Nclex note?
all narcotics:
- reduce pain
- cause physical dependence
- lower respirations
- should not be used with alcohol
- lowers blood pressure
- causes constipation
Memory trick’s for opioids?
Low and slow: BP RR HR Brain
when do we stop and give the antidote narcan?
1.) LOW RR- respiratory depression
Hold dose for RR below 12. Remember that we always tech deep breathing exercises to prevent pneumonia and atelectasis. but remember that if the patient does not practice this we still give medication and do not hold it.
when do we stop and give the antidote narcan?
1.) LOW RR- respiratory depression
Hold dose for RR below 12. Remember that we always tech deep breathing exercises to prevent pneumonia and atelectasis. but remember that if the patient does not practice this we still give medication and do not hold it.
2.) Low BP-Hypotension
orthostatic hypotension, you need to teach the patient to go slow so slow position changes.
- Low brain- CNS depression
key terms:
unarousable
easily falls asleep when talking
if the client becomes dizzy or lightheaded then what do you do?
place then in a sitting position immediately.
they cannot get up unassisted. so teach them to use the call light to get out of bed.
if the patient overdoses on heroin and opioid what do we give?
naloxone IS GONE QUICKLY SO WE NEED TO GIVE MULTIPLE DOSES
NALONE key points:
- 1-2 hour half life
- so we always have to reassess every 60 minutes
- monitor for a persistent low and slow
- RR below 12
- unarousable
- falling asleep when talking to you
- prepare for a 2nd dose of naloxone
- notify hcp
would you call rapid response?
not unless the airway and breathing are critically low like RR below 12 and O2 below 90%
how to administer IV opioid’s like morphine or hydromorphone (dilaudid)?
- administer OVER 2 TO 3 MINUTES IV PUSH.
- reassess every 15 to 30 minutes.
greatest risk for death?
advanced age
copd, asthma=respiratory disease
post-surgery 24 hours
if given an option for patients both with respiratory disease who do you pick?
- ) oldest patient 1st
2. ) most recent surgery= 24 hours
normal side effects that you do not need to report?
- ) burning sensation is normal during IV push just dilute it and give it slower next time.
- ) pruritus- just give antihistamine
- ) nausea and vomiting when 1st starting= as nausea develops tolerance improves. so give antiemetic like ondansetron. but po opioid’s give with food. do not give on an empty stomach since it increases the nausea.
long term side effects of opiods?
low and slow GI = constipation
Key terms:
PRN STOOL SOFTNERS
TEACH PREVENTIVE MEASRES LIKE FIBER, FLUIDS, AND AMBULATION.
Does constipation get worse with long term administration ?
yes. but just because it does not mean that you would hold the opioid you continue giving it to the patient.
oxycodone aka percocet
what is it used for and how does it work?
typically used for extended release and it has a slower onset.
used for severe chronic pain like cancer pain
it is given twice a day with other painkillers.
when it oxycodone given?
“as scheduled” or “around the clock”
- EVEN IF NOT REPORTING PAIN
- GIVEN TOGETHER WITH OTHER PAIN MEDS
PCA pumps? key point?
only the client is allowed to push it not their family, nurse, or HCP.
When would you alert the HCP to increase the dose?
only when twice the dose of the medication is given.
if the patient still reports pain. what is the first action?
assess their pain level 1st.
fentanyl key points:
it is usually used as a patch for chronic PERSISTENT pain. NOT INTERMITENT NOT ACUTE NOT POST-OP PAIN ONLY CHRONIC PAIN
IT DOES NOT PROVIDE IMMEDIATE PAIN RELIEF DUE TO IT TAKING 17 hours to get the full effect.
- APPROPRIATE TO USE IF PATIENT IS ALLERGIC TO CODEINE
- side effect? constipation so use stool softeners daily
how to know if patient has developed tolerance?
need increase doses for pain relief
how to place a fentanyl patch?
remove the old patch before the new one
clean the area
place the patch over dry skin
