Task Solutions Of Nursing Consideration for Morphine:NURS2037

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Case Study
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Case Study
Nursing Consideration for Morphine
A nursing consideration i …

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Case Study
Student ’sName
Institution
Course
Professor
Date
2
Case Study
Nursing Consideration for Morphine
A nursing consideration is arespiratory depression that may be caused by morphine.
Respiratory depression is the main risk of morphine. It occurs more frequently among elderly
patients and those suffering from hypoxia, upper airway obstruction, and hypercapnia (Telford,
2020). In this regard, the nurse should be extremely cautious since the patient is old and they
have decreased respiratory reserve. For the patient, the normal therapeutic dose of morphine may
significantly increase their airway resistance and further reduce the respiratory drive to apnea.
The drug should be supervised closely at the lowest effective dose among such patients.
Additionally, morphine tends to induce respiratory depression by activating the u-opioid
receptors at certain locations in the central nervous system, like the pre-Botzinger complex, a
respiratory time that generates the areas of the pons (Telford, 2020). Opioids like morphine
negatively impact breathing with the onset and offset profiles that are defined by the drug
transmission to the receptor cells. This process affects partial morphine agonists like
buprenorphine as controlled by the transmission to the receptor site with dissociation kinetics.
The opioid-induced respiratory depression is considered to be fatal to the patient.
However, if itoccurs, itcan be inverted by the opioid receptor adversary naloxone. It is an agent
that specifically has ashort-removal half-time. The receptor kinetics that often needs reversal is
the rate-restricting factor in the naloxone-reversal of the opioid impact (Keskin et al.,2021). The
agents that have slow disassociation kinetics usually need continuous naloxone infusion, whereas
the agents that have rapid kinetics will tend to showcase acomprehensive reversal after asingle
dose of naloxone. Besides, the drug is non-discerning and will therefore reverse analgesia. The
exertions are concentrating on developing compounds responsible for reversing opioid-induced
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respiratory depression without impacting the efficiency of analgesics. Such agents consist of
various elements, including ampakines and serotonin agonists, focused more on reducing the
respiratory depression from the opioid-activation of the microglia cells in the brainstem using
micro-GIA cell stabilizers. Since the approach concurrently improves the opioid analgesic
effectiveness, itwill be the best option to the classical reversal plan with naloxone.
Pain Relief Strategy
A non-pharmacological method best suits the patient during the postoperative period is
using acupuncture. It is aform of complementary therapy which involves inserting the thin
needles into certain acupoints. Through this, itmay relieve pain by releasing endorphins, which
are considered to be anatural pain-killing chemical. It further affects the part of the brain
responsible for governing serotonin, which is linked to mood. Generally, the procedure is
deliberated to be safe, and its complications are low (Gumus et al., 2020). Various reviews of
acupuncture-related complications have reported that the most serious issues were accidental
insertion of the needle into the pleural space between the lungs and the walls of the chest. The
strategy will help stimulate the body’s meridians of the patient and correct imbalances. It will
further help to restore their health (Gumus et al., 2020). Such benefits are speculated to come
from the proximity of the acupoints with the nerves through intracellular calcium ions. The
strategy has also been proved to enhance the endogenous opiates, including endorphins and
encephalin, and produces corsicoreoids that relieve pain and further enhance the healing process.
Other benefits are linked to acupuncture. The first benefit is itreduces stress. Stress is
considered to be among the various reasons why the majority of individuals seek acupuncture
treatment (Patil et al., 2016). Acupuncture has, over the years, been proved to decrease the stress
hormones and further moderate the mood by reducing anxiety and enhancing the overall feeling
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of happiness. Secondly, itrelieves tension in the neck and further relieves both pains in the hands
and arms. The strategy works by offering drug-free pain relief while decreasing sinflammation
and swelling. It also reduces headaches. It may reduce migraines and bring about asense of
relaxation and euphoria. Besides, itis considered the most effective compared to drugs. Thirdly,
acupuncture is known to decrease eye strain and improves the immune system. It may assist in
relieving eye strain that is linked to neck tension. It further helps the body fight pathogens by
boosting the patient’s immune system (Patil et al., 2016). Acupuncture has also been reported to
decrease the duration of cold and decrease disturbing symptoms, which makes someone feel
mysterious. The fourth benefit is itenhances mental clarity and increases energy. Over the years,
individuals who have used acupuncture have reported acupuncture helped in their mental clarity
and further improves their sleep, which in this case will ensure that the patient receives quality
life. It may further help eliminate any allergies that the patient may experience.
Nursing Consideration of Colostomy
Nurses need to inspect the stoma and the periosteal skin area while changing the pouch.
Through this, they will be able to note the irritations, bruises, and rashes. The process will
significantly help them in monitoring the healing process and the effectiveness of the appliances.
It will further help identify any areas of concern that require further evaluations and interventions
(Zelga et al., 2021). The early identification of the stoma necrosis or fungal infections noted from
the changes in the normal bowel flora allows for timely interventions that will assist in the
prevention of serious complications. Nurses should be aware that stomas should always be red
and moist. Additionally, the ulcerated areas on the stoma may result from such an opening that is
too small or from the faceplate that tends to cut from the stoma. For the patients with ileostomy,
the effluent tends to be high in enzymes which further increases the probability of patients
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contracting skin irritations. However, for colostomy, the skincare routine is not considered a
great concern since the enzymes are not present in the effluent.
The nurse should further be aware that the skin surrounding the stoma should be the same
as the skin that is around the abdomen. Therefore, they should ensure that they help in keeping
the skin healthy. They can do this by implementing various strategies. The first strategy is using
the right size pouch and the skin barrier opening (Zelga et al., 2021). Openings that tend to be
small may injure or cut the stoma and result in swelling. Therefore, if the opening is large, the
output may get to and cause irritation to the skin. In such cases, the nurse needs to change the
pouch and further replace itwith one that fits well. Secondly, the nurse should change the
pouching system more regularly. Through this, they will be able to avoid leaks that will lead to
skin irritations. It is essential to have asignificant regular schedule for changing the poach. The
nurse should not wait for leaks and other problems like itching to manifest, leading to further
complications (Zhang et al., 2019). They should be careful when pulling the pouching system
away from the skin and avoid removing itmore than once daily unless there is an issue. The skin
barrier can gently be removed by pushing the patient’s skin from the sticky barrier instead of
pulling the barrier away from the skin. The skin around the stoma should be cleaned with water
and dried completely before placing the barrier on the skin. It Is necessary to watch for any
forms of allergies which may develop after weeks or months after certain products have been
used.
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References
Gumus, K., Musuroglu, S., Karaman Ozlu, Z., & Tasci, O. (2020). Determining the use of
Nonpharmacologic methods by surgical nurses for postoperative pain management and
the influencing professional factors: A multicenter study. Journal of PeriAnesthesia
Nursing ,35 (1), 75-79. https://doi.org/10.1016/j.jopan.2019.04.011
Keskin, G., Ak ın, M., Şenayl ı,Y., Öztorun, C. İ.,& Bah çecitapar, M. (2021). Effects of 5µg/kg
intrathecal morphine for postoperative analgesia in pediatric patients undergoing major
surgery. Der Anaesthesist .https://doi.org/10.1007/s00101-021-01040-4
Patil, S., Sen, S., Bral, M., Reddy, S., Bradley, K. K., Cornett, E. M., Fox, C. J., & Kaye, A. D.
(2016). The role of acupuncture in pain management. Current Pain and Headache
Reports ,20 (4). https://doi.org/10.1007/s11916-016-0552-1
Telford, A. (2020). Role of the nurse in supporting the safe use of opioids. Nursing
Standard ,35 (9), 77-82. https://doi.org/10.7748/ns.2020.e11534
Zelga, P., Kluska, P., Zelga, M., Piasecka-Zelga, J., & Dziki, A. (2021). Patient-related factors
associated with stoma and peristomal complications following fecal ostomy
surgery. Journal of Wound, Ostomy & Continence Nursing ,48 (5), 415-
430. https://doi.org/10.1097/won.0000000000000796
Zhang, Y., Xian, H., Yang, Y., Zhang, X., & Wang, X. (2019). Relationship between
psychosocial adaptation and health ‐related quality of life of patients with stoma: A
descriptive, cross ‐sectional study. Journal of Clinical Nursing ,28 (15-16), 2880-
2888. https://doi.org/10.1111/jocn.14876

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