Opioid Analgesics: Just in Time Training September 2006
Opioid Analgesics: Just in Time Training September 2006
Opioid Analgesics: Just in Time Training September 2006
Objectives
Upon completion of this course the participant will:
Identify three groups of analgesics used for pain management. Identify the 3 most common opioid analgesics used at Passavant Hospital for pain management. Be familiar with the side effects/adverse reactions of opioid analgesics. Identify nursing considerations for opioid analgesics. Identify reversal agents for selected opioid analgesics.
Opioid Analgesics
This Just in Time education will spotlight opioid analgesics. Mu agonist opioids are the most commonly used. This group includes:
Morphine Hydromorphone (Dilaudid) Codeine (Tylenol #3) Oxycodone (Percocet/OxyContin/OxyIR ) Hydrocodone ((Vicodin/Lortab) Meperidine (Demerol) Propoxyphene (Darvon/Darvocet N 100)
Peak action occurs in 15 minutes to 2 hours, depending on drug and route Duration of action is from 2 to 8 hours
Perform/provide: Evaluate:
1.
2.
3. 4.
Nurse monitor sedation level and respiratory status q1-2h during the first 24h in opioid-naive patients treated for moderate to severe pain. *Note: If administering opioid analgesic IV bolus check patient within 10 to 15 minutes of administration. Add or increase nonopioid or nonsedating adjuvants so that the opioid dose can be reduced. Decrease opioid dose by 25% when excessive sedation is detected. If patient is minimally responsive or unresponsive to stimulation, stop opioid administration and consider administering naloxone (Narcan).
Patients who require Narcan usually meet all of the following criteria:
Unresponsive to physical stimuli Shallow respirations or respiratory rate less than 8 breaths/minute Pinpoint pupils
*Taken from McCaffery & Pasero: Pain: Clinical Manual, pp. 262-264, & 2701999, Mosby, Inc
Please review the following procedures located on the Passavant Intranet under Manual /ResourcesNursing Procedures
Patient Controlled Anaglesia (PCA Pump) PCA Flow Sheet (Guidelines for)
Charting #6010-060 Verbal/Telephone Physicians Orders (Read Back) #6010-026 Pain Management #710-37 Medication Administration #6010-064 Medication Administration Range Orders #6010-130 Monitoring of Vital Signs #710-72 Patient Controlled Analgesia (PCA) Pump # 6010-071
Summary
This course has provided you with a concise review of opioid analgesics. You have been encouraged to review corresponding policies and procedures related to the administration of opioid analgesics. A more in-depth review of the policies and procedures for pain management will be assigned to you in October.
Thank you for taking the time to read this material. To complete this course you need to complete the post test. Click on the take test button to the left. If you have any questions please contact your nurse manager, supervisor, or clinical director.