NURS 5 Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name

Codeine

Trade Name Acetaminophen Tylenol 3 Peak

A:1-3 hours C:60-120 minutes

Classification
Antipyretics/ non opioid analgesics /opioid analgesics

Dose
300 mg/ 30mg

Route
PO

Time/frequency
Every 6 hrs. PRN for pain

Onset
0.5-1 hour 30-45 minutes

Duration
3-8 hours 4 hours

For IV meds, compatibility with IV drips and /or solutions N/A Nursing Implications (what to focus on) Contraindications/warnings/interactions
A: Hypersensitivity. Use cautiously in pts w/ malnutrition. Interacts w/ hepatotoxic substances and NSAIDs. Do not give more than 4 g of acetaminophen in 24 hours. C: Contraindicated in hypersensitivity. Use cautiously in head trauma, increased intracranial pressure, Severe renal, hepatic, or pulmonary disease, hypothyroidism, Adrenal insufficiency.

Mechanism of action and indications (Why med ordered)

A: Inhibits the synthesis of prostaglandins that may serve as mediators of pain and fever, primarily in the CNS. Indicated for treatment of mild pain. C: Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression.

Common side effects

A: Hepatotoxicity, renal failure, neutropenia, pancytopenia, leucopenia, rash, and urticaria C:confusion, sedation, hypotension, constipation, nausea, vomiting

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)
NSAIDS, increased sedative effect with other CNS depressants.

Lab value alterations caused by medicine

May alter results of blood glucose monitoring, Increased serum bilirubin, LDH, AST, ALT, and prothrombin time may indicate hepatotoxicity. May cause and increase in serum amylase and lipase concentrations.

Be sure to teach the patient the following about this medication

Advise patient to consult health care professional if discomfort or fever is not relieved by routine doses of this drug or if fever is greater than 39.5C (103F) or lasts longer than 3 days. Oral doses may be administered with food or milk to prevent GI irritation.

Nursing Process- Assessment (Pre-administration assessment)

Assess for Pain: intensity, location, duration etc. Assess respirations, number, depth, quality, and if <10 assess for level of sedation. Assess bowel function regularly. Institute bowel protocol including increased intake of fluids and fiber to prevent constipation.

Assessment Why would you hold or not give this med?

If the patient reports no pain or if respirations are less than 12

Evaluation Check after giving

Decrease in Level of pain reported by the patient with minimal side effects.