Student Name: __Erin Nowlin____________________
Client Allergies: NKDA
DOSAGE
PURPOSE
ROUTE & FLUID CLASSIFI
OF
DRUG
FREQUENC TYPE
CATION
DRUG
Y
(Indication)
Generic: Client:
Primar
hydromor 1 mg IV every y:
phone
hour as needed
HCl
N/A
Pharmacologi
c
Classification
:
Opioid
analgesic
_
Brand:
Isotonic
Usual:
_
Dilaudid 2-4 mg by
Hypoton
mouth every
ic
4-6 hours as
_
Action (patho):
needed, or 1-4 Hyperto Unknown,
Onset:
mg IM, SQ, or nic
Binds with
10-15 min IV (slowly
opioid
Peak: 15- over 2-5
receptors in
30 min
minutes) every Seconda the CNS,
Duration: 4-6 hours as
ry:
altering
2-3 hr
needed for
perception of
pain
N/A
and emotional
response to
pain.
Specific to
the
Client:
Severe pain
Date of Care:__June 20, 2011
MAJOR
NURSING
IMPLICATIONS
Adverse Reactions (3):
CV: bradycardia
Respiratory: respiratory depression, bronchospasm
GI: constipation
Interactions: (2)
Other opioid analgesics: may cause additive effects. Use together with
caution.
Alcohol use: May cause additive effects. Discourage use altogether
Usual:
Moderate to
severe pain
Pain scale =
Effects on Labs: (all)
May increase amylase and lipase levels.
May interfere with hepatobiliary imaging studies because delayed
gastric emptying and contraction of sphincter of Oddi may increase
biliary tract pressure.
Nursing
Considerations (3):
Reassess patient’s level of pain at least 15 and 30 minutes after
administration
Monitor respiratory rate and circulatory status and bowel function.
Drug may worsen or mask gallbladder pain.
Client Teaching(1):
Instruct patient to request or take drug before pain becomes intense.
Antidote:
Naloxone
Black Box Warning:
Dilaudid-HP, a highly concentrated form (10mg/mL), may be given in
smaller volumes to prevent discomfort of large-volume IM or SQ
injections. Don’t confuse Dilaudid-HP with standard parenteral
formulations. Check dosage carefully.
eferences: Lippincott, Williams, & Wilkins. (2010). Nursing 2011 drug handbook, 31 ed. Philadelphia: Wolters Kluwer.
MATH
CALCU
LATIO
NS
gtt/min:
N/A
mL/hr:
N/A
Push
rate:
Give IV
inj over
no less
than 2
minutes
Dilution
:
Give
undiluted
(Show all
math)