Opioid Analgesics
Included In This Lesson
Study Tools For Opioid Analgesics
Outline
Overview
- Opioids are given for moderate to severe pain
- They will not provide the same relief as an epidural
- They are typically given IV in labor and fast-acting
- Given PO in the postpartum period to treat pain
Nursing Points
General
- Ideal to be given when needed for breakthrough/acute pain during labor, not chronically throughout pregnancy
- Newborn can be born addicted→ refer to addicted newborn lesson
- History taking is essential before administration to make sure they haven’t been taking them during pregnancy
- Some meds are contraindicated if someone is already dependent on specific meds, as they may elicit withdrawal symptoms for both baby and mom
Assessment
- Patient history
- Pain level
- How close is the patient to delivery
Therapeutic Management
- Medicate properly
- Hydromorphone (Dilaudid)
- Morphine
- Butorphanol tartrate (Stadol)
- Nalbuphine (Nubain)
- Oxycodone
- Hydrocodone
- Naloxone available
- Anti nausea medications
- Nausea is a side effect of Opioids
- Monitor for overdose
- Respirations less than 12/min is a concern
- Hypotension
Nursing Concepts
- Pharmacology
- Comfort
- Safety
Patient Education
- Fast acting
- Treatment options
Transcript
In this lesson I will help you understand the various opioids that are used as analgesics and when you will use them.
Alright opioids are used to treat pain that occurs. So they are given for moderate to severe pain. In labor they are usually given IV so that they act fast. They aren’t going to provide the same numbing effect as an epidural would. During the postpartum period period they are used to treat pain and usually given PO. So for cramping, incisional pain, or episiotomy pain.
The patient will need assessment for her history. We need to know if she has been taking opioids throughout the pregnancy or has a history of opioid use or abuse in her history. We want to know this so we don’t give opioids fi she has a history of use and abuse or if she currently takes them we need to know for the newborn care since they can be born addicted. You can refer to the lesson on the addicted newborn for more on that. The patient’s pain level should also be assessed so we can medicate her properly and we need to know how close she is to delivery if she is a laboring patient. If she is close to delivery and we give a narcotic it can cause respiratory depression in the newborn which we don’t want. Let’s review medications that are given.
We need to manage our patient with proper medications. So during labor medications like Hydromorphone, Morphine, Butorphanol tartrate or stadol, Nalbuphine or nubain are options to give. In the postpartum time frame the most widely used opioid medications are Oxycodone and Hydrocodone. And with these opioids we want to have naloxone or narcan available to reverse any overdose effects and have for delivery of the newborn if delivery happens too soon after opioids are given.
Additional management besides the opioid analgesia and Naloxone being available will be anti nausea medications because this is a side effect of Opioids and we want to monitor for overdose. So a patient that has respirations less than 12 a minute is a concern and hypotension are things we will watch for. We will educate the patient on the medication options and that they are fast acting.
Pharmacology and safety are our concepts because we are talking about medication and the safety of the patient is important when giving opioids.
Ok so what is important? Opioids are used as analgesics during labor and in the postpartum period. They are fast acting but will not take away pain during labor the same as an epidural. Naloxone should be available to reverse any overdosage and available at delivery for the newborn to reverse respiratory depression.
Make sure you check out the resources attached to this lesson and review the key points. Now, go out and be your best selves today. And, as always, happy nursing.
review all the things
Concepts Covered:
- Cardiovascular
- Emergency Care of the Cardiac Patient
- Cardiac Disorders
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Upper GI Disorders
- Newborn Complications
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Multisystem
- Neurological
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Test Taking Strategies
- Medication Administration
- Respiratory Disorders
- Pregnancy Risks
- Labor Complications
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- EENT Disorders
- Basics of Chemistry
- Adult
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Documentation and Communication
- Preoperative Nursing
- Endocrine System
- Legal and Ethical Issues
- Basics of NCLEX
- Communication
- Understanding Society
- Immunological Disorders
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Eating Disorders
- Prenatal Concepts
- Anxiety Disorders
- Depressive Disorders
- Oncology Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Gastrointestinal Disorders
- Circulatory System
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Nervous System
- Microbiology
- Hematologic Disorders
- Emergency Care of the Trauma Patient
- Newborn Care
- Digestive System
- Urinary Disorders
- Postpartum Care
- Infectious Respiratory Disorder
- Integumentary Disorders
- Terminology
- Concepts of Population Health
- Musculoskeletal Disorders
- EENT Disorders
- Postpartum Complications
- Postoperative Nursing
- Neurological Emergencies
- Vascular Disorders
- Disorders of Thermoregulation
- Statistics
- Neurological Trauma
- Cardiovascular Disorders
- Basic
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Delegation
- Perioperative Nursing Roles
- Developmental Considerations
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Renal Disorders
- Concepts of Pharmacology
- Integumentary Important Points
- Fetal Development
- Renal and Urinary Disorders
- Community Health Overview
- Developmental Theories
- Labor and Delivery
- Infectious Disease Disorders
- Musculoskeletal Disorders
- Basics of Human Biology
- Psychological Emergencies
- Adulthood Growth and Development
- Growth & Development
- Female Reproductive Disorders
- Sexually Transmitted Infections
- Proteins
- Hematologic Disorders
- Tissues and Glands
- Somatoform Disorders
- Oncologic Disorders
- Skeletal System
- Basics of Sociology
- Bipolar Disorders
- Emotions and Motivation
- Peripheral Nervous System Disorders
- Central Nervous System Disorders – Spinal Cord
- Neonatal
- Male Reproductive Disorders
- Prioritization
- Pediatric
- Psychological Disorders
- State of Consciousness
- Sensory System