How to properly dilute morphine?

Nurses Medications

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Hi everyone! Nursing student here and the other day in clinical I was giving a patient 4 mg IVP morphine for pain. Well I know I was supposed to dilute it and I know im supposed to give it over 5 minutes. What I didn't understand was the dilution. My instructor had me grab a 5ml syringe and fill it with 4 mls of saline then I took the 4ml bottle of morphine which was 4ml/4mg and fill the syringe until it got to 5 and then that was it? So was the patient not getting the full dose or was it able to mix in with all the saline? I just thought I would need a 10 ml syringe the math doesn't make sense to me.

Persephone Paige, ADN

1 Article; 696 Posts

The math doesn't make sense to me either.

if it was an order for your patient what would be your step by step process for drawing up 4mg/4ml?

Persephone Paige, ADN

1 Article; 696 Posts

Well, I haven't given Morphine in a very long time. And if we diluted it, I don't remember it. We just drew it up and wasted the mgs that we didn't use. But, if I were to dilute it, I sure wouldn't use 4cc. I might use 2cc and a 6cc syringe, making 1cc of sterile water to every 2mg/2cc of Morphine. Easy to measure, depending on the dose ordered. We have things that look like carpojets in our hospital, not sure if they come diluted or not.

Wuzzie

5,116 Posts

1 hour ago, Almostanurse19 said:

Hi everyone! Nursing student here and the other day in clinical I was giving a patient 4 mg IVP morphine for pain. Well I know I was supposed to dilute it and I know im supposed to give it over 5 minutes. What I didn't understand was the dilution. My instructor had me grab a 5ml syringe and fill it with 4 mls of saline then I took the 4ml bottle of morphine which was 4ml/4mg and fill the syringe until it got to 5 and then that was it? So was the patient not getting the full dose or was it able to mix in with all the saline? I just thought I would need a 10 ml syringe the math doesn't make sense to me.

Are you certain the concentration was 4mg/4ml? That is an odd formulation. 4mg/1ml is more common. It’s an important detail and makes the difference between undermedicating your patient (a med error) and an okay but probably not the best method of dilution.

Specializes in NICU, RNC.

This is really a question for your clinical instructor while you had the order and the vial in front of you. I would never recommend just administering a drug that you feel you may be drawing up incorrectly. Your instructor will appreciate your desire for clarification, speak up!

JKL33

6,768 Posts

On 3/1/2019 at 3:08 AM, NICUismylife said:

This is really a question for your clinical instructor while you had the order and the vial in front of you. I would never recommend just administering a drug that you feel you may be drawing up incorrectly. Your instructor will appreciate your desire for clarification, speak up!

This can't be overemphasized.

I wrote out a similar reply last night but it was coming off too strongly and I didn't mean it that way.

Specializes in Wound care; CMSRN.

Was there any left in the vial? I've never seen 1mg/ml MS; not saying it doesn't exist. 5 minutes seems excessive for that dose, but whatever. Follow policy at all times.

4mg/4ml is a rather unusual dose. I personally have seen 4mg/2ml at most. As the poster above has stated I would look into the hospital policy and what your clinical instructor has to say. Every hospital is different in how they do things.

bananas1

59 Posts

I don't know much about morphine but I am guessing it was probably 4mg/ml.. so by taking 1ml out you would have your 4mg. Why it went in saline I don't know ?

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