Fluctuations in pulse
Patient behaviors: grimacing and crying
Skilled nursing assessment
The patient's self report
Addiction is very rare when opioids are used in patients with pain.
Emotional or spiritual distress may affect a patient's experience of pain and its severity.
Respiratory depression from opioids is very rate and occurs only after a patient has a decreased level or arousal.
Opiate-associated constipation often resolves over time so laxatives can be used sparingly.
Risk of aspiration due to sedation
Risk of dependence
Risk of paradoxical worsening of delirium
Risk of respiratory depression when used with opioids
Decreased bowel fluid secretion and/or increased absorption
Decreased tone of bowel musculature
Opioid binding to gut and central nervous system opioid receptors
Increase in non-propulsive activity