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Did he get too much morphine?



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No. 20
from Dolce
Old Apr 17, 2008, 01:11 AM

Default Re: Did he get too much morphine?
I would never give morphine 8 mg all at once. Generally you start out with 2-4 mg IV q 30 min-1 hour and see how that works. If the patient was in the PACU I can see how she might have wanted to give 8 mg but still not all at once. You are supposed to titrate medication to effect. She wasn't titrating anything if she gave it all at once.

As a side note...when I was in nursing school we would have been expelled from the program for administering ANY IV medication unsupervised. Even in my final semester I had to have supervision AT THE BEDSIDE for any IV administered medication. Sounds like this nursing student is marching to the beat of her own drum. Hope she doesn't kill anybody in the process.
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No. 21
from NRSKarenRN
Old Apr 17, 2008, 01:27 AM

Default Re: Did he get too much morphine?
Who said the RN instructor wasn't there?

Please be cautious about reading INTO posts things that are not there and making assumptions....

I'd need a lot more info before making a decision re morphine dosing i.e.
a. amount of PO analgesics patient taking prior to surgery
b. prior medical history/co-morbidities
c. pain history esp if chronic pain for other condition
d. height AND weight
e. recreational drug use
f. response to pain meds immediately prior to this time interval


All of these factors influence amount of morphine I'd give....not just the 8 mg...might have needed 12mg to keep him comfortable at level HE chooses to accept.
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No. 22
from SMK1
Old Apr 17, 2008, 01:27 AM

Default Re: Did he get too much morphine?
Originally Posted by Blee O'Myacin View Post
I have more of an issue with a student nurse giving an IV push drug without supervision than I do with the dosage.

Blee
This is what I was thinking. I am shocked that this is allowed.
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No. 23
from suanna
Old Apr 17, 2008, 01:52 AM

Default Re: Did he get too much morphine?
Apparently it wasn't too much- your brother is still breathing. Morphine is pretty short acting. I think the dose was generous, but if you brother is under 60y/o and over 120lbs more will probable serve him better than less. For pain management get the pain under copntrol and then keep it there. If my patients aren't sleepy I haven't given enough pain meds to keep them comfortable.
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No. 24
from tanthalas
Old Apr 17, 2008, 02:00 AM

Default Re: Did he get too much morphine?
8 mg does seem like a bit much. When was his last PRN for pain? I guess the student took the concept of "treat pain aggressively at the start" a bit too much.

At least the patient is getting his thrills on morphine, though!
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No. 25
from AprilRNhere
Old Apr 17, 2008, 02:12 AM

Default Re: Did he get too much morphine?
Originally Posted by Blee O'Myacin View Post
I have more of an issue with a student nurse giving an IV push drug without supervision than I do with the dosage.

Blee
We gave push drugs all the time as students without supervision. By the last semester we were cleared- she'd seen us do enough of them to know we were ok. As my CI handed me the med..she'd ask me to tell her what rate and what side effects I'm watching for. If I could answer...I was allowed to give the med.
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No. 26
from Virgo_RN
Old Apr 17, 2008, 02:54 AM

Default Re: Did he get too much morphine?
Originally Posted by Aprilhere View Post
We gave push drugs all the time as students without supervision. By the last semester we were cleared- she'd seen us do enough of them to know we were ok. As my CI handed me the med..she'd ask me to tell her what rate and what side effects I'm watching for. If I could answer...I was allowed to give the med.
Same here.
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No. 27
from Angie O'Plasty, RN
Old Apr 17, 2008, 03:27 AM

Default Re: Did he get too much morphine?
I'm pretty large, but if anyone gave me that much morphine, I'd probably have to be narcan'd out of it!

I don't ever recall giving that big a dose to someone in mild-mod pain.

Would I say it was too much? It really depends on the things Karen mentioned above.
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No. 28
from SMK1
Old Apr 17, 2008, 04:53 AM

Default Re: Did he get too much morphine?
Originally Posted by Aprilhere View Post
We gave push drugs all the time as students without supervision. By the last semester we were cleared- she'd seen us do enough of them to know we were ok. As my CI handed me the med..she'd ask me to tell her what rate and what side effects I'm watching for. If I could answer...I was allowed to give the med.
It is illegal for that to happen in my state and I'm guessing others as well so that is probably why some of us are shocked. Clearly all RN students have probably given their fair share of IV push meds, it is just surprising that things are not as strict in other places on this issue. (then again this is nursing so why am I shocked! lol)
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No. 29
from Tweety
Old Apr 17, 2008, 04:59 AM

Default Re: Did he get too much morphine?
You're correct. It's too much based on the assessment of light to moderate pain. For that kind of pain some p.o. pills or a lower dose of Morphine should have been offered.

It's not too much for an adult in an acute moderate to severe pain to get. Lightheadedness and sleepiness are side effects of morphine and you really shouldn't be overly concerned with those side effects.
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