A postoperative client receiving opioid analgesia is difficult to arouse, has respirations of 6/min, and has oxygen saturation of 82%. Complete the emergency response.
Drop-down Cloze
Choose your responses, then check the answer.
Explanation
Profound sedation, respirations 6/min, and hypoxemia during opioid therapy indicate a life-threatening opioid-induced respiratory emergency. The immediate priorities are to stop opioid administration, activate emergency help, support the airway and ventilation, provide oxygen, and administer naloxone according to the order or emergency protocol. Naloxone can wear off before the opioid, so the nurse maintains continuous surveillance for recurrent respiratory or central nervous system depression and prepares additional supportive measures or repeat naloxone as indicated.
Correct Answer Stop further opioid delivery, call for emergency help, support airway and ventilation, administer naloxone according to the order or protocol, and continue close monitoring for recurrent depression.
Why It Fits The client is not merely sleepy. Bradypnea, severe hypoxemia, and difficulty arousing show failure of ventilation and central nervous system depression during opioid exposure.
Clinical Picture Naloxone reverses opioid effects, but its duration may be shorter than the opioid's. Initial improvement does not end the emergency; respiratory depression can recur.
Memory Link Ventilate, reverse, and watch again.
NCLEX Rule Airway and breathing support occur with, not after, the medication response. Do not wait for naloxone alone to correct severe hypoxemia.
Why the Alternatives Fail Waiting or adding a sedative worsens depression. Resuming the opioid after transient awakening ignores recurrence risk. Bowel, sleep, and skin concerns are lower priority than ventilation.
Source
1FDA Naloxone Hydrochloride Injection Label
2Joint Commission Opioid Monitoring Requirements
32026 NCLEX-RN Test Plan
The nurse remains with the client, activates the facility's emergency response, stops further opioid delivery, and has oxygen, ventilation equipment, and naloxone available. Prescribed reversal is titrated according to the clinical protocol while ventilation is supported.
Opioid-induced respiratory depression — Reduced central respiratory drive from an opioid, causing slow or shallow breathing, hypoxemia, and potentially unresponsiveness.
Naloxone — An opioid antagonist used to reverse opioid-related respiratory and central nervous system depression.
Recurrent respiratory depression — Return of respiratory or central nervous system depression after initial reversal because the opioid effect outlasts naloxone.