NURS 2466 Clinical Form 3: Clinical Medications Worksheets(You will need to make additional copies of these forms)

Generic NameMeperidine

Trade NameDemerol

ClassificationOpioid analgesics

Dose25 mg/1 mL

RouteIVP

Time/frequencyQ 2hrs PRN pain

Peak5-7 minutes

Onsetimmediate

Duration2-3 hrs

Normal dosage range50-150 mg q3-4 hr. prn pain

Why is your patient getting this medicationPain r/t bowel obstruction

For IV meds, compatibility with IV drips and/or solutionsDilute to a concentration of 10 mg/ml with sterile water or NS; administer slowly over at least 5 min.

Mechanism of action and indications(Why med ordered)Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli, while producing generalized CNS depression. Indicated for moderate to severe pain

Nursing Implications (what to focus on) Contraindications/warnings/interactions.Use cautiously in severe hepatic disease

Common side effectsConfusion, sedation, hypotension, constipation, nausea, vomiting

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)Increased sedative activity with other CNS depressants.

Lab value alterations caused by medicineCan cause increased serum amylase and lipase

Be sure to teach the patient the following about this medicationMay cause drowsiness or dizziness. Advise patient to call for assistance when ambulating, Advise patient to change positions slowly to minimize orthostatic hypotension, Encourage patient to turn, cough, and breathe deeply every 2 hr to prevent atelectasis

Nursing Process- Assessment(Pre-administration assessment)Assess type, location, intensity of pain and vitals before administration.

AssessmentWhy would you hold or not give this med?Would hold if pain is at acceptable level or if respirations were less than 10.

EvaluationCheck after givingRe-assess type, location, and intensity of pain. Continually monitor respirations, bp, and pulse for excessive CNS depression which would be evident by respirations less than 10 per minute, pulse less than 60. Check orthostatic hypertention. Monitor for delirium and normeperidine toxicity which would be evident by CNS stimulation