401010 Health Variations-Opoid Pain Medication
• An understanding of the principles of perioperative nursing care in relation to a person who has ulcerative colitis
• An understanding of alterations in body fluid homeostasis and the management of fluid balance in the perioperative period
• An understanding of the role of the nurse in the perioperative period in relation to a person who has ulcerative colitis
• An understanding of the pathophysiology of ulcerative colitis
• An understanding of pharmacological agents that may be used in the perioperative care of a person who has ulcerative colitis
• An understanding of how safe and effective administration of pharmacological agents support people in perioperative care
• An evaluation of relevant literature to support an understanding of the pathophysiology, pharmacological and nursing management of a person experiencing Crohn’s disease and express this in a clear and succinct writing style.
Answer:
Morphine is an opoid pain medication, which belongs to the narcotic drug family, administered to give the relief from moderate to severe pain to the patient. However, there are several considerations, which should be followed by the patients and nurses’ prior administering morphine, as it has several side effects, which can be alleviated by some specific conditions of patients. Thus the key responsibilities of the nurse to administer morphine to Eleanor include the followings:
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Nursing responsibilities |
Rationale |
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Check for allergies |
The narcotic drug can develop adverse side effects leading to allergy, which would elevate patient’s health issues |
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Monitor the area of pain and measure pain score |
As the drug is administered for relieving pain, the severity of pain should be measured to decide the dosage |
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Check heart rate and blood pressure, presence of asthma or breathing problem |
Morpphine can worsen the symptoms |
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Double check doctor’s administration order for the drug |
The drug has severe adverse effects and it should not be consumed until provided by doctor, thus nurse should ensure that it is ordered by the physician |
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Check for proper dosage and proper route of administration |
It is an addictive drug, for which the dosage must be at a safe level, reducing the chance of addiction, else, overdose can be fatal |
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Need to double check the dosage |
As Eleanor has renal impairment i.e. ulcerative colitis, for which additional precaution in dosage would be required to eliminate the risk of adverse effects |
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Check the site of administration and protocol carefully |
To reduce administration site inflammation |
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Take patient consent |
For ethical consideration |
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Check the other medications taken by the patient at a time |
Some drug like MAO inhibitors can interact with the drug with adverse effects |
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Check for sedative use |
Some sedative can interact with the drug with adverse effects |
Ulcerative colitis is a chronic, relapsing inflammatory disease of colon, which is a form of inflammatory bowel disease. The disease can be an aggressive course or have a slow progress rate. The more part of the colon is involved, the more severe the disease and the looser the stools, because, the inflamed colon is unable to absorb properly. Bloody stool is a hallmark symptom of ulcerative colitis. With the progress of the disease and increased inflammation in colon, open sores are formed in large intestine, which can irritate the point of bleeding.
In ulcerative colitis, the blood comes into the stool along with mucus or pus, the blood directly comes from the rectum, during the flare up and relapses. In the ulcerative colitis small lesions of abscesses are formed in the wall of intestine, during the bowel movement, due to flare ups and relapses, the bleeding is caused from those abscesses, thus, with the disease progress, i.e. more area becoming involved in inflammation and formation of more sores in intestine causes more blood in stool, as a result the amount of haemoglobin is reduced along with increased erythrocyte sedimentation rate.
In case of Eleanor, the similar incidents happened, as her ulcerative colitis has now extended to large intestine, more blood is being released with enhanced inflammation. Inflammation is causing cytokine secretion and activation of more WBC, which acts at inflammation site and develops pus.
For Eleanor, Hartman’s solution has been ordered as the IV fluid to maintain her fluid balance status. The compound is a sodium lactate intravenous infusion BP. Sodium lactate solution is supplied for administering sufficient fluid and salts to the body, in which the salt concentration is similar to the body fluid, i.e. blood. Through a vein drip the solution is supplied to Eleanor. It is administered if a patient has lost adequate amount of blood, then it is needed to be replaced for a short time. Based on the blood pathology results, doctor decided her dosage, i.e. 1000 mL over 6 hours. Administration of this solution would restore the fluid balance, which was impaired by loss of mineral salts through blood.
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