Duramorph Morphine Case Study
Duramorph (morphine)
Classifications: Opioid
Route: intrathecally or epiduarally. Larger doses increase the side effects without increase the length of time the drug works. Nurses don’t give this??
OB use: For pain 24 hours after birth/most commonly used with C sections.
Side Effects: pruritus, nausea and vomiting, and urinary retention
Nursing implications: works in 30-60 minutes.
Contraindications: allergy/hypersensitivity to morphine.
Maternal Side effects: most common: confusion, sedation, constipation, hypotension, pruritus, urinary retention, nausea, and vomiting.
Can cause resp depression which can cause neuro problems. Give they are obese taking mag. Sulfate or have sleep apnea are at a greater risk for resp depression. …show more content…
Inform pt of potential side effects, check pain scale, if they are allergic to sulfate it may cause allergy, can give naloxone (Narcan) or diphenhydramine per dr orders. Asses resp rate before and after giving (if less then 12 breaths per minutes) assess urinary output and bladder distension. Help pt to walk, don’t drink on this drug, can cause withdawls if you discontinue abruptly.
Naloxone (Narcan)
Class: opioid antagonist
Ob Use: used to reverse the mild resp depression caused by butorphanol (Standol, nalbuphine (Nubain) and meperidine hydrochloride (Demerol), sedation, and hypotension following small doses of opiates. NOTE: this is the drug of choice when the cause of resp depression is unknown./Given to the laboring mother or newborn.
Route: To mother: may be injected undiluted at a rate of 04.mg over 15sec into the tubing of a running IV. Also can be diluted in 5% dextrose (more often in postop settings when epidurals are given for c section) For Neonates IV, IM, ET. Standard dosage is 0.01mg/kg
Contraindications: Don’t give to women of baby’s with known dependency to narcotics.
Side Effects:
Maternal/Fetal …show more content…
Side Effects Maternal: hyperstimulation of uterus can cause the following – water intoxication, rapid labor (uterine rupture), impaired uterine blood flow leading to hypoxia of fetus.
Side effects fetal: hyperbilirubinemia for augmentation of labor/hypoxia related to over contraction.
Nursing implications: explain to pt how it works/apply fetal monitor and obtain 15-20 min tracing and nonstress test of FHR before starting/for induction and augmentation start primary IV and piggyback secondary IV with oxytocin and infusion pump/max rate is 40milliunits per min/discontinue and infuse primary solution when nonreassuring FHR – contractions happen more then q2mins –duration is more the 60 secs – insufficient relaztion of uterus between contrations (also turn on side and if nonreassuring FHR continues then admin oxygen 7-10L/min/keep up with intake and output levels.
Depo- provera (DMPA):
Class: Long acting progestin contraceptives (contains no
Classifications: Opioid
Route: intrathecally or epiduarally. Larger doses increase the side effects without increase the length of time the drug works. Nurses don’t give this??
OB use: For pain 24 hours after birth/most commonly used with C sections.
Side Effects: pruritus, nausea and vomiting, and urinary retention
Nursing implications: works in 30-60 minutes.
Contraindications: allergy/hypersensitivity to morphine.
Maternal Side effects: most common: confusion, sedation, constipation, hypotension, pruritus, urinary retention, nausea, and vomiting.
Can cause resp depression which can cause neuro problems. Give they are obese taking mag. Sulfate or have sleep apnea are at a greater risk for resp depression. …show more content…
Inform pt of potential side effects, check pain scale, if they are allergic to sulfate it may cause allergy, can give naloxone (Narcan) or diphenhydramine per dr orders. Asses resp rate before and after giving (if less then 12 breaths per minutes) assess urinary output and bladder distension. Help pt to walk, don’t drink on this drug, can cause withdawls if you discontinue abruptly.
Naloxone (Narcan)
Class: opioid antagonist
Ob Use: used to reverse the mild resp depression caused by butorphanol (Standol, nalbuphine (Nubain) and meperidine hydrochloride (Demerol), sedation, and hypotension following small doses of opiates. NOTE: this is the drug of choice when the cause of resp depression is unknown./Given to the laboring mother or newborn.
Route: To mother: may be injected undiluted at a rate of 04.mg over 15sec into the tubing of a running IV. Also can be diluted in 5% dextrose (more often in postop settings when epidurals are given for c section) For Neonates IV, IM, ET. Standard dosage is 0.01mg/kg
Contraindications: Don’t give to women of baby’s with known dependency to narcotics.
Side Effects:
Maternal/Fetal …show more content…
Side Effects Maternal: hyperstimulation of uterus can cause the following – water intoxication, rapid labor (uterine rupture), impaired uterine blood flow leading to hypoxia of fetus.
Side effects fetal: hyperbilirubinemia for augmentation of labor/hypoxia related to over contraction.
Nursing implications: explain to pt how it works/apply fetal monitor and obtain 15-20 min tracing and nonstress test of FHR before starting/for induction and augmentation start primary IV and piggyback secondary IV with oxytocin and infusion pump/max rate is 40milliunits per min/discontinue and infuse primary solution when nonreassuring FHR – contractions happen more then q2mins –duration is more the 60 secs – insufficient relaztion of uterus between contrations (also turn on side and if nonreassuring FHR continues then admin oxygen 7-10L/min/keep up with intake and output levels.
Depo- provera (DMPA):
Class: Long acting progestin contraceptives (contains no