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How to properly dilute morphine?

Medications   (843 Views 10 Comments)
by Almostanurse19 Almostanurse19 (New Member) New Member Nurse

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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.

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Persephone Paige has 15 years experience as a ADN and works as a Med-Surg.

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The math doesn't make sense to me either.

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

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Persephone Paige has 15 years experience as a ADN and works as a Med-Surg.

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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.

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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. 

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NICUismylife is a ADN, BSN, RN and works as a NICU RN.

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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!

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11 hours ago, 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.

 

 

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Tomascz has 3 years experience as a ASN, CNA, RN and works as a CMSRN.

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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.

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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.

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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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