1. Document indications for therapy.

2. Note any prior experience with opioid analgesics such as an adverse reaction with the drug or category of drugs prescribed.

3. Monitor vital signs at every appointment because of cardiovascular and respiratory side effects.

4. Have the patient sit up slowly and remain seated for at least two minutes after being supine in order to minimize the risk of orthostatic hypotension.

5. Decreased saliva flow can put the patient at risk for dental caries, perio-dontal disease, and candidiasis.

6. When used as sedation for outpatient procedures, someone must accompany client. Expect a recovery period (to assess for any adverse side effects) of up to several hours before release.

7. Psychologic and physical dependence may occur with these medications.

8. NSAIDs may be beneficial if additional analgesia is necessary.

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