help please! morphine side effects! - page 2

so a resident has been prescribed .1ml of mophine. when checking out the bottle and narcotics sheet the resident had 30ml. the last person to give the medication wrote 29ml. STUPIDLY ive been reading... Read More

  1. Visit  CapeCodMermaid} profile page
    0
    Our morphine comes in a 30cc vial. The usual concentration is 20mg/cc.It's given sublingually. Every nurse and doctor has been educated and re-educated to write "give 5mg (0.25cc) every hour as needed for pain or respiratory distress."
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  3. Visit  RNGriffin} profile page
    0
    Your question is the side effects of Morphine overdosage in a PT with HX of anxiety...The symptoms may be acute, but the more prevalent will be resp. depression. Given the time frame of the last dosage and when antivan was administered, the likely result will be fatigue which could last up to 48 hours after administration. The Resident should be fine, but you definitely should alert other medical staff who may be attending to the patient, as Resp. failure, brachycardia, etc. are at higher risk in patients whose nervous systems are already compromised, due to anxiety. A watchful eye on vital signs for the next 24hrs will be ideal. But, this is all depending on the length of admission...
    It's rare that the results will be fatal. But, please be more cautious in your administration of narcs, especially if you are uncertain. Morphine is used heavily in OR patients to induce a more effective anesthetic.
  4. Visit  loriangel14} profile page
    0
    Did you not realize you were giving 10mls of morphine? That is a high dose. I would have questioned it.
  5. Visit  surferbettycrocker} profile page
    0
    the order for .01 ml should come with either a) magnifying glass to dispense .01 ML or b) clarification of said order to mgs. was she supposed to get 0.1 mg of morphine for ....?
    i suspect if you looked at it twice and mistook the 1ml for .01 ml you are not the only one.

    was this oral morphine?
    Last edit by surferbettycrocker on May 28, '12 : Reason: .
  6. Visit  tothepointeLVN} profile page
    0
    From what I can understand of the first post it was MS 10mg/mL The bottle had 30mL in it before it was opened. The first nurse gave whatever dose she gave then documented that there was 29mL left in the bottle

    So our OP read the order as give 1mL and crosschecked that by the fact that 1mL was missing from the bottle also.

    1mL at 10mg/mL doesn't sound totally out of the ballpark if we are assuming that this is given PO/SL and not IM/IV. I often work with MS @ 20mg/mL and for severe pain our orders are often to give 20mg / 1mL. 1mL of MS PO/SL isn't a heck of a lot.

    Was it written .1mL without a leading zero. Could it have been just a tiny little pen dot. Being send out 36 after receiving the MS probably means the two events weren't correlated (probably)
  7. Visit  missnurse2012} profile page
    2
    thank you all for the advice and comments! so it was brought to my attention that i did give the correct dose. the person informing me of my " mistake " was looking at another persons chart!!!! can you believe it??!? they both have the same medication but different dose. the whole thing was a huge mix up and unfortunately at my expense since ive been worrying apparently for no reason. but thank you all the same for your input!
    maelstrom143 and tewdles like this.
  8. Visit  redhead_NURSE98!} profile page
    3
    Is it wrong of me to nitpick at those of you who typed ".1" instead of "0.1?"
    mc3, maelstrom143, and sapphire18 like this.
  9. Visit  tothepointeLVN} profile page
    3
    So the person who informed you of the mistake was in fact mistaken? Ahh the irony.
  10. Visit  MattNurse} profile page
    1
    Quote from missnurse2012
    i feel so stupid and hopeless. i dont know if im cut out for all this.
    It happens, you aren't stupid if you make a mistake you are just human. Nor is your co-worker stupid for their error.

    You are stupid if you don't learn from your mistakes.
    LTCangel likes this.
  11. Visit  Elizabeth 1953} profile page
    1
    I am so sorry that you went thru that .Thank goodness it ended well for you.But in a way it helped you learn just how easy a mistake can be made and the problems of not clarifying the orders correctly.I believe that some of these problems occur due to being over worked and under so much stress as a nurse.Being a nurse is a very stressful career.You or anyone else may make a mistake.It happens.The main thing is to learn from the mistakes and not make yourself feel incompetent.Always double check yourself and do not give a dose of med or perform the order until you have double checked it no matter how busy you are.And always clarify orders if they are not clear.This is your license,and I am sure you want to keep it.If you do make a mistake,tell someone asap so it can be corrected or assessed for potential problems.I hope you do not leave your career over a mistake.Even the best nurse can make a mistake.I feel that the mistakes you make can lead you to become a better nurse when you learn from them.You become more aware and pay even closer attention to things.Just take some slow breaths and start a new day.Happy things worked out for you.Remember none of us are perfect.
    jadelpn likes this.
  12. Visit  tewdles} profile page
    0
    As others have intimated, the "mistake" was actually the providers, for writing an improper medication order.
  13. Visit  tothepointeLVN} profile page
    0
    Unfortunately I see a lot of orders like this for Roxanol / MS where the volume is stated rather than the doseage.
  14. Visit  tewdles} profile page
    0
    Quote from tothepointeLVN
    Unfortunately I see a lot of orders like this for Roxanol / MS where the volume is stated rather than the doseage.
    I imagine that all of us nurses know that this is a "bad practice" setting the scene for serious medication errors. I am surprised that your nursing or facility management does not put a stop to it for their own corporate liability reasons.


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