Management of Oral Morphine Hydrochloride Administration

Description

• The mixture (Delta West brand) contains morphine 1 mg/ml (=1000 micrograms/ml), glycerol (less than 10%), methylhydroxybenzoate (preservative) in a citrate-buffered clear aqueous vehicle.

• Charted on prescription chart as morphine mixture in mcg/dose.

Administration

1. Administer with a small volume of milk.
2. When dose is <50 micrograms, dilution to 500 micrograms/ml is necessary.
3. Using a 1 ml syringe, draw up 0.5 ml water ensuring the hub of the syringe does not contain water.
4. Using a 2nd 1 ml syringe and needle, draw up 0.5 ml morphine hydrochloride 1 mg/ml priming hub of syringe and needle.
5. Dispense morphine into the water and mix well.
6. Prime to ordered dose.

Observation and Documentation

1. Evaluate the baby's need for medication.
2. Evaluate baby's response to medication.
3. Assess for signs of adverse effects.
4. Monitor respiratory status carefully.
5. Assess oxygenation and document.
6. Observe stools for volume and character.
7. Record baby's dose out of the narcotic register.
8. When diluting morphine to 500 micrograms/ml, record balance discarded out in the narcotic register.
9. Two nurses must witness the discarding of the unused diluted drug down the sink and syringes into the sharps container.

Storage

• Store in the controlled drug safe.
• Expiry date is six months from date of opening bottle, or manufacturers expiry date - whichever is shorter.

References