Back to nursing after several (and I do mean several) years off. Hence I haven't given morphine in quite some time. Just wondering about IV morphine preparation for extremely small doses in the NICU.
Ordered 0.05 mg morphine slow IV push q 4-8. On hand morphine 2 mg/ml. How far do you dilute the concentration? If you make it 1:1, you can't possibly draw up 0.05 cc in a 1 ml syringe. And how do you make it 1:1? Just add 1 cc NS to vial?
I don't want to appear to be a complete idiot, but the practical aspects (i.e. the actual physical prep and admin of certain things) have left me over the years.
May 24, '08
We do a serial dilution. 0.1 ml of the med, 0.9 ml of NS (or whatever diluent is compatible). If your dose is 0.05, you would give 0.5 ml of your dilution.
We have 2 mg/ml morphine as well, so in this case the you would be giving 0.025 ml. After the serial dilution you would be giving 0.25 ml, not 0.5 like I originally said.
Last edit by preemieRNkate on May 25, '08
: Reason: clarification
To Preemie RN Kate and Steve. Thanks for the input. I came up with 0.25 cc for the dose if diluted out to 0.2 mg morphine/ml. Because if you draw up 0.1 ml of the 2 mg/ml concentration and add 0.9 ml NS, you still have 0.2 mg/ml. It's not a 1:1 mix. Does that make sense?? I tend to be a bit anal and check and recheck my calculations.
I've only ever done NICU during my nursing career. I wouldn't even consider any other area. And I know the margin for error is non-existent with the little micros. I want to make sure I'm doing everything correctly, and do what's best for the babies.
Last edit by dance45 on May 25, '08
: Reason: spelling