Question

1. List recommended IV dose ranges and frequency of doses for the following medications:

a. Morphine:

b. Hydromorphone (Dilaudid):

c. Fentanyl citrate (Sublimaze):

2. George Good is a 64 year old male who has a history of Chronic Kidney Disease Stage 3. He was admitted 2 days ago because he was involved in a motor vehicle accident where he dislocated and fractured his left ankle. You review his morning labs and notice his Creatine was 3.0 mg/dL. At 1200 Mr. Good rates his pain a 6 out of 10. Which of the following pain medication orders would you question the physician and not give this patient and why?

a. IV Toradol 30mg q6hrs PRN

b. PO Acetaminophen 325mg q6hrs PRN

c. PO Oxycodone 5mg q6hrs PRN

3. Greta VanFleet is 24 hours post-op from a Right Knee Replacement. When you go in to do a pain assessment, Greta states her pain as a 8 on a 1-10 pain scale at 1700. Greta has an order for oxycodone 5mg/acetaminophen 325mg 1 to 2 tablets PO q6hrs PRN for moderate to sever pain.

a. For what condition(s) is oxycodone indicated?

b. For what conditions(s) is acetaminophen indicated?

c. What is the usual recommended adult dosage range?

d. What is the maximum recommended daily dosage of acetaminophen?

Answer 1

1.a.morphine is used in acute and chronic pain.it is used for terminal ill patients or cancer patients.actually first morphine should be administered slowly over 4-5 mins.starting dose of morphine is 1-2 mg per day in adults.for cancer patients dose may be increased.

B.hydromorphone is used for severe pain for cancer patients.dose for continuous iv is 0.5-2.5mg per hour.dose may be changed according to patients Tolerability.

C.fentanyl citrate is also an opiod.dose is 50 microgram/ml in iv.

2.here patient was having chronic kidney disease.creatinine level is 3 mg/dl.so here the safest pain killer will be acetaminophen.both toradol and oxycodone can't be given in renal insufficiency.

3.oxycodone and acetaminophen both are used as painkillers.adult dose of acetaminophen is 500mg tds.it should be calculated by BMI.maximum daily dose will be 650 mg tds.