24.02 Opioid Analgesics in Pregnancy

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Outline

Overview

  1. Opioids are given for moderate to severe pain
    1. They will not provide the same relief as an epidural
  2. They are typically given IV in labor and fast-acting
  3. Given PO in the postpartum period to treat pain

Nursing Points

General

  1. Ideal to be given when needed for breakthrough/acute pain during labor, not chronically throughout pregnancy
    1. Newborn can be born addicted→ refer to addicted newborn lesson
  2. History taking is essential before administration to make sure they haven’t been taking them during pregnancy
  3. Some meds are contraindicated if someone is already dependent on specific meds, as they may elicit withdrawal symptoms for both baby and mom

Assessment

  1. Patient history
  2. Pain level
  3. How close is the patient to delivery

Therapeutic Management

  1. Medicate properly
    1. Hydromorphone (Dilaudid)
    2. Morphine
    3. Butorphanol tartrate (Stadol)
    4. Nalbuphine (Nubain)
    5. Oxycodone
    6. Hydrocodone
  2. Naloxone available
  3. Anti nausea medications
    1. Nausea is a side effect of Opioids
  4. Monitor for overdose
    1. Respirations less than 12/min is a concern
    2. Hypotension

Nursing Concepts

  1. Pharmacology
  2. Comfort
  3. Safety

Patient Education

  1. Fast acting
  2. Treatment options