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21 Cards in this Set

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Why does the hcp provide morphine sulfate?
relieves chest discomfort
that is unresponsive to
NTG
What does morphine sulfate relieve?
MI pain
decreases myocardial oxygen
demand
relaxes smooth muscle
reduces circulating
catecholamines
How is morphine sulfate administered?

maximum prescribed dose is reached or until client experiences relief or signs of toxicity
2- to 10-mg doses IV every
5 to 15 minutes until when?
What are adverse effects of morphine?
respiratory depression
hypotension
bradycardia
severe vomiting
What is the treatment for morphine toxicity?
naloxone (narcan) 0.2 to 0.8
mg IV
vasopressors
admnistration of IV fluids
oxygen therapy

so monitor VS and cardiac rhythm every few minutes
What therapeutic class does morphine belong to?
opioid analgesic
It's pharmacologic classification is?
opioid agonist
The indications for morphine are?
severe pain
pulmonary edema
pain associated with MI
(been used to treat CHF for years)
The MOA of morphine is?
binds to opiate mu receptors in
CNS, blocking the release of substance P,
alters the perception of and
response to painful stimuli
while producing
generalized CNS depression
decrease in severity of pain
What should nurse assess?
<LOC
blood pressure
pulse
respirations>
Assess level of sedation if respiratory rate is less than?

physical stimulation
10/min...what can prevent significant hypoventilation?
Prolonged use may lead to?
physical and psychological dependence
Instruct family not to administer PCA doses to sleeping patient. What can result?
overmedication
sedation
respiratory depression
Have patient reposition slowly due to?
<hypotension>
Encourage patients who are immobilized or on prolonged bedrest to?
turn, cough, and breathe deeply every 2 hrs to prevent atelectasis.
What GI problem should be aggressively prevented with morphine use?
constipation
Effectiveness of therapy can be demonstrated by?
decrease in severity of pain
without a significant
alteration in LOC or
respiratory status
decrease in symptoms of
pulmonary edema
In what 2 forms is morphine legally available?
Morphine is legally available only in the form of its water-soluble salts. Most common are morphine sulfate and morphine hydrochloride. Both are fine white crystalline powders, bitter to the taste. Both are soluble in water and slightly soluble in alcohol.
Constipation is a serious side effect of all opioids. What are nursing interventions for this?
assess previous bowel habits
start prophylactic treatment
including pushing fluids,
encourage activity, give
foods high in bulk and
roughage
keep a record of bowel
movements
administer stool softeners
and stimulant laxatives
if ineffective, try
suppository or Fleet's
enema
Brand names of morphine?
Avinza
Duramorph
Kadian
Morphitec
Roxanol
When switching morphine sulfate (opioid agonist), use an ______ _____ to determine equivalencies between other opioid agonists. Do not mix full agonists with mixed agonist-antagonists. Combine opioids with NON-OPIOID adjuvants.
equianalgesic chart