Clinical patient care questions

[enfermeratobe]

I have clinical bright and early tommorrow morning and just received my patient assignment tonight. I am doing my work up and see that my patient is on a lot of pain meds , bowel meds, and antiemetics. I start to feel nervous as when I am going through side effects with my medications a lot of them are the respiratory depression , decrease pulse and high levels of sedation due to my patient being geriatric. This makes me nervous to say the least when I have morphine , ambien, Norco and others on my list. I wrote my clinical instructor with my concerns and he said since I feel nervous tommorrow morning he will be asking me what my plan is to keep my patient safe. My plan so far is to monitor RR rate pulse BP and neuro checks before medication administration. As well as throughout the day to ensure there in no change in LOC I will also adhere to whether or not it is 1 assist 2 assist etc for ambulation as there is an increase risks for falls as far as the blood thinner he is on I will monitor for any s/s of bleeding hemmorhagjng etc. any other advice one can give before I go in tommorrow?

[dishes, BSN, RN]

Is the patient taking the medications for chronic or acute pain management?

[TheCommuter, BSN, RN]

This makes me nervous to say the least when I have morphine , ambien, Norco and others on my list.

I am guessing that the morphine, Norco and Ambien are most likely PRN medications that are given as needed. If so, your worries might be somewhat overblown since these drugs are not administered unless they are actually needed.

A prudent floor nurse would monitor for oversedation and respiratory depression before giving the drugs. If any of these are present, a competent nurse would not administer them.

[enfermeratobe]

I was not given that information unfortunately :/

[YoutubeTheNP]

What floor are you going to be on in the hospital, tele/ med/surg, etc? The medications you are describing is nothing out of the ordinary, so don't get too nervous. Almost everyone inpatient has a sleeping pill on their emar prn. Norco, morphine, is also very common, norco usually for mild pain (5-7), and morphing for severe pain (8-10). With any narc, monitor VS, respiratory rate for sure, level of consciousness (lethargy, stupor, etc). I have seen narcotic addicted patients barely able to speak sentences to me because they are so drugged up and telling me their pain is 10/10, use your judgment when giving narcotic pain meds. You mentioned fall risk which is a good observation as well. As a student you should also know the reversal agent for opioids.