NURS 1566 Clinical Form 3: Clinical Medications Worksheets(You will need to make additional copies of these forms)

Generic NameHydrocodone/acetaminophen

Trade NameLortab

Classificationopioid agonists/nonopioid analgesic combinations

Dose5/500mg tabs; give one to two

RoutePO

Time/frequencyPRN q 3-4hours

Peak30-60 min

Onset10-30 min

Duration4-6 hr

Normal dosage rangeAnalgesic-2.5-10 mgq 3-6 hours, acetaminophen should not exceed 4g per day

Why is your patient getting this medicationChest pain r/t pleural effusion

For IV meds, compatibility with IV drips and/or solutionsN/A

Mechanism of action and indications(Why med ordered)Bind to opiate receptors in the CNS. Alter the perception of and response to painful stimuli while producing generalized CNS depression. Indicated for pain.

Nursing Implications (what to focus on) Contraindications/warnings/interactionsHypersensitivity to hydrocodone, Hypersensitivity to acetaminophen.Do not give more than 4 grams of acetaminophen in a 24 hour period.

Common side effectsconfusion, sedation, hypotension, constipation

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)None known

Lab value alterations caused by medicineMay cause increased plasma amylase and lipase concentrations

Be sure to teach the patient the following about this medicationAdvise patient to take medication exactly as directed and not to take more than the recommended amount. Severe and permanent liver damage may result from prolonged use or high doses of acetaminophen. Renal damage may occur with prolonged use of acetaminophen or aspirin. Doses of nonopioid agents should not exceed the maximum recommended daily doseInstruct patient on how and when to ask for pain medicationMay cause drowsiness or dizziness. Advise patient to call for assistance when ambulatingAdvise patient to change positions slowly to minimize orthostatic hypotension. Encourage patient to turn, cough, and breathe deeply every 2 hr to prevent atelectasisAdvise patient that good oral hygiene, frequent mouth rinses, and sugarless gum or candy may decrease dry mouth

Nursing Process- Assessment(Pre-administration assessment)Assess blood pressure, pulse, and respirations before and periodically during administration. Assess type, location, and intensity of pain prior to and 1 hr (peak) following administration.

AssessmentWhy would you hold or not give this med?Pt reports no pain or has respirations less than 12 per minute.

EvaluationCheck after givingDecrease in severity of pain without a significant alteration in level of consciousness or respiratory status