Opium alkaloids and synthetic narcotics such as meperidine (Demerol ) are narcotic
agonist that have an affinity for certain receptor sites and depress brain cells involved in
b. Morphine and codeine act mainly on the central nervous system (CNS) where
they produce a combination of depressing and stimulating effects. Papaverine has little
effect on the nervous system, but produces relaxation of certain smooth muscles. The
analgesic effect of morphine is indicated for the treatment of severe pain. Morphine
may be administered orally, intramuscularly, intravenously, subcutaneously, epidurally,
c. Frequently seen side effects of opioid use include vertigo, faintness, and
lightheadedness, occurring most often in ambulatory patients. Less frequently seen
side effects include dry mouth, headache, anorexia, abdominal cramping, nervousness,
increased anxiety, mental confusion, urinary retention or painful urination, visual
disturbances, and nightmares. Among the more serious adverse reactions are
seizures, tinnitus, jaundice, breathing difficulties, and respiratory depression.
d. Nursing care implications consist of properly accounting for narcotics,
observing the patient's response to the analgesic, and recording the degree and
duration of pain relief and any adverse effects that may occur. Naloxone hydrochloride
(Narcan ) is an opioid antagonist; that is, it can reverse opioid-induced respiratory
depression and sedation by displacing the opioids at the receptor site. Naloxone should
be available on nursing units where opioid medications are used.
a. This subcourse has introduced the basic nursing care techniques and
procedures involved in the nursing care related to the musculoskeletal system.
b. Review the lesson objectives once again. If you feel confident that you have
achieved the lesson objectives, complete the exercises at the end of this lesson.
c. If you do not feel that you have met the lesson objectives, review the
necessary material before you attempt the end of lesson exercises.