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Opioid Pain Pharmacology Analgesics Nursing RN PN for NCLEX

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Hey guys nurse mike here and welcome to simple nursing calm before we get today’s lecture started please remember check out our brand new app and get access to our new pharmacology and med-surg mastery courses plus 11 other courses like fundamentals pediatrics maternity mental health and more complete with over 300 follow along cheat sheets and a massive quiz bank

Loaded with detailed rationales to test your knowledge join for free click the link in our description below all right guys let’s begin here’s to opioids the three tips for opioids number one is opioids guys think o’s for low and slow vitals they are cns depressants meaning they bind to the opioid receptors in the brain which sedates the body so again the memory

Trick opioids we have low and slow vitals so low heart rate low respirations low bp and a slow brain which makes them very deadly and again they’re not nsaids so there’s no antipyretic properties so it’s not gonna reduce a fever and there’s no anti-inflammatory properties so guys it’s not good for gout or rheumatoid arthritis directly second is opioids have the

O’s so guys morphine sulfate has a no hydromorphone coding oxycotin and oxycodone now the weird one here is fentanyl which will cover another segment but really all of them kind of sound like foam so guys remember to phone the doctor if you see low and slow vital signs now tip number three is the killer side effects when do we stop and give the antidote narcan

Well guys low respiratory rate key term here is respiratory depression and the key number we hold dose for respiratory rate below 12 now we’re always going to teach deep breathing exercises to prevent that atelectasis and pneumonia but key word here we never hold the drug if the patient has not cracked they’re deep breathing exercises so we still give them it now

For low bp aka hypotension or orthostatic hypotension we teach patients to go slow so slow position changes to prevent fall risks now key term if the client becomes dizzy or lightheaded guys immediately assists the patient to a seating position do not get up unassisted so teach the patient to use the call light when getting out of bed now lastly the low brain for

The cns sedation key term here is easily falls asleep when talking and unallowable guys we hold any additional narcotics so monitor the respiratory status and guys sedation comes before respiratory depression so be sure to watch out for this now you may give addition narcotics when the patient’s loc or level of consciousness improves so when they’re easily aroused

Or only slightly drowsy now if things get too low and slow and our patient starts to overdose we can always give the antidote naloxone brand name narcan whoo it’s an opioid antagonist meaning it’s a reversal agent for opioid overdose as well as heroin overdose now the memory trick is we think of the x in naloxone puts an x on the o’s and the opioids guys the bad

News is that it’s gone quickly so we usually have to give multiple dose so think naloxone is gone quickly so the key point here to write down is one to two our half-life so we always have to reassess every 60 minutes and we’re monitoring for the persistent low and slow so guys the key terms here to write down a respiratory rate below 12 on arousal falling asleep

While talking to you that was a really big one as well as prepare for the second dose of narcan and notify the hcp if we have any of these key terms present and guys don’t worry about calling a rapid-response we always assess the patient and prepare the narcan since this is an expected response now lastly guys the priority nursing care is aims so remember first

Is a for assess the abcs this is priority during a respiratory sedation is for intervention of oxygen m is for make the hcp aware and s is for a second dose of naloxone and guys again there’s no need to call for a rapid response unless the airway and breathing are critically low so below 12 respirations or below 90 percent o2 sats now as far as iv administration

Of opioids like morphine and hydromorphone guys we minister over two to three minutes iv push bakey term not over 5 to 10 seconds a fast push usually means a fast death and we reassess after 15 to 30 minutes not after an hour those are usually 4 p o opioids now the greatest risk for death is for overdose and respiratory depression and our patients with advanced

Age 70 years or older or underlying pulmonary disease like copd or asthma and even post-surgery 24 hours usually these are stressed on the question banks as the highest risk for death so big tests up here if you’re given an option between two patients both with respiratory disease for the most at risk for respiratory depression related to opioids guys always choose

The oldest patient first or the most recent surgery now for short-term side effects that are normal no need to report to the hcp a burning during iv push well guys that’s perfectly fine we don’t have to hold the medication for this we just dilute it and give it a little slower next time how about per itis a ka-ching well that’s also common no need to report we just

Tree with antihistamine like benadryl and for nausea when first starting taking the med key point here write this down teeps that the tolerance will develop and nausea will improve so give antiemetics initially like own dosterone brand-name zofran and 4p o opioids we take with food not on empty stomach which may increase the risk for nausea now for long-term side

Effects we get a low and slow gi leading to you constipation so key term here is prn stool softeners and teach preventative measures like fluid fiber and moving like ambulation basically walking now constipation gets worse over long-term administration and it doesn’t get better like the nausea so many students wanted to hold morphine for a patient with a no bowel

Movement for two days guys we continue to give this and a little side note for oxycodone guys just think oxycodone is like an old ox with a slower onset typically used for extended release so typically for severe chronic pain an example of cancer pain not like immediate release opioids which acts faster there’s a slower onset and extended release usually over 12 hours

So we give it twice a day and yes guys we administer it together with other pain meds so key words to write down we give it a scheduled around-the-clock big one right here even if not reporting pain and we commonly give it together with other pain meds now for pca pumps aka patient controlled analgesia pump the indication is it’s usually used after surgery for long

Term recovery now how it works is a certain amount of medication is set into the pump and each time the button is pressed it delivers that medication so key points here guys client only can push the button no one but the client will push the button not the family not the nurse not the doctor so guys nursing care here when do you notify the hcp for an increased dose

Well only if the patient attempts are twice the dose of the med given so if the patient still reports pain well the first action for you guys to do is a thorough pain assessment so be careful tests will always ask for the best nursing response or the priority action in the nclex world the priority is always assessment before intervention because nclex wants you to

Follow the nursing process so guys remember the acronym air a for assessment before i intervention and then r for reassessment now for fentanyl one of the most potent narcotics noon to mankind now sorry to be so creepy guys but guys fentanyl is one of the main reasons why a lot of people are overdosing during this opioid crisis fentanyl is a very potent narcotic

For use for severe pain now fentanyl patch is the form it usually comes in so it’s used for chronic pain so guys just think patches are for persistent pain not acute pain and it does not provide immediate pain relief since patches are absorbed slowly and it can take up to 17 hours for full effect so guys it’s not to be used for acute pain so keywords here not for

Post-op pain or intermediate pain you always want to clarify the order with the hcp now it is appropriate for allergies to coding now as far as patient teaching kaplan says that a fentanyl patch the big side effect is constipation so we use stool softeners daily and ati says that tolerance has developed if increased doses are required for pain relief and as far

As hesse we always remove old patches before applying new ones and you cleanse the area that the old patch was on and always place the patch over dry skin thanks for watching for our full video and new quiz bank click right up here to access your free trial and please consider subscribing to our youtube channel last but not least a big thanks to our team of experts

Helping us make these great videos alright guys see you next time

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Opioid Pain Pharmacology Analgesics Nursing RN PN for NCLEX By Simple Nursing