MEDICATION SHEET

Name & Admin

(Generic &
Brand name;
Dosage, route,
frequency)
Hydrocodone
Norco
5 mg/ 325 mg
Oral
PRN q4h

Mechanism of Action (Classification,

physiologic actions)

Side Effects

Nursing Responsibilites &

Patient Teaching

Narcotic agonist.
Inhibits synthesis of prostaglandins and
binds to opiate receptors in CNS and
peripherally blocks pain impulse generation;
produces antipyresis by direct action on
hypothalamic heat-regulating center;
causes cough suppression by direct central
action in medulla; may produce generalized
CNS depression.

CNS: lightheadedness,
dizziness, sedation,
drowsiness, mental
clouding, lethargy,
impairment of
mental and
physical
performance,
anxiety, fear,
dysphoria,
psychological
dependence, mood
changes, stupor,
coma.
CV: bradycardia,
cardiac arrest,
circulatory
collapse,
hypotension.
EENT: hearing
impairment,
permanent hearing
loss.
GI: nausea,
vomiting,
constipation,
abdominal pain,
gastric distress,
heartburn, peptic
ulcer.
GU: urethral
spasms, spasm of
vesical sphincters,
urine retention,
renal tubular
necrosis, renal
toxicity.

Monitor patients closely for an

allergic reaction, particularly
those who are allergic to other
opioids.
Alert: Carefully monitor vital
signs, pain level, respiratory
status, and sedation level in all
patients receiving opioids,
especially those receiving I.V.
drugs, even those given
postoperatively.
Monitor patients for signs and
symptoms of drug dependence
or abuse.
Monitor respiratory status.
Monitor patients who have had a
head injury.
Use of opioids in patients with
acute abdominal disorders may
mask symptoms.
Constipation is a very common
adverse effect. Treat constipation
aggressively.
Monitor liver and kidney
function. Acetaminophen
elimination may be increased in
patients with hepatic
impairment.
Monitor patients ability to
urinate; report urine retention.
Monitor BP and pulse regularly.
Make sure to use a calibrated
measuring device to administer
oral solution.
Black Box Warning: Keep track of
the amount of acetaminophen
given on a daily basis. Be sure
its less than 4,000 mg daily.For

Rationale for use

with this patient
Provide pain relief.

Hematologic:
thrombocytopenia,
agranulocytosis,
occult blood loss,
hemolytic anemia,
iron deficiency
anemia, prolonged
bleeding time.
Hepatic: hepatic
necrosis, hepatitis,
increased LFT
values.
Metabolic:
hypoglycemia,
hypoglycemic
coma.
Musculoskeletal:
muscle flaccidity.
Respiratory:
respiratory
depression, acute
airway obstruction.
Skin: rash,
pruritus, cold
clammy skin,
diaphoresis.
Other: allergic
reaction.

best results, instruct patient to

take drug before pain becomes
severe.
Explain the assessment and
monitoring process to the patient
and family. Instruct them to
immediately report if the patient
has any difficulty breathing or
any other signs of a potential
adverse opioid-related reaction.
Inform patient that its very
important to take this medication
only as prescribed.
Caution patient that this
medication can be habit forming,
and a tolerance to the dose may
develop.
Advise patient that this
medication may impair judgment
and not to operate heavy
machinery or drive until the
drugs effects are known.
Instruct patient to avoid alcohol
while taking this medication.
Black Box Warning: Warn patient
that this medicine contains
acetaminophen (or Tylenol).
Caution patient not to take more
than 4,000 mg of acetaminophen
on a daily basis (including from
all medications being taken).
Instruct patient to contact health
care provider if he has taken
more than 4,000 mg in a day,
even if he is feeling well.
Teach patient to eat a high-fiber
diet, drink plenty of fluids, and
use a stool softener or bulk
laxative to prevent constipation.
Tell patient to stop drug and
immediately report blurred
vision, rash, or yellowing of the
skin.
Alert: Warn patient to stop drug
and seek medical attention
immediately if rash or reaction

occurs while using

acetaminophen