Clinical context A 68-year-old opioid-naive postoperative cl… | MyMerci
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Adverse Effects/Contraindications/Interactions

Clinical context A 68-year-old opioid-naive postoperative client with obstructive sleep apnea and stage 3 CKD is receiving hydromorphone PCA plus scheduled gabapentin and becomes difficult to arouse with shallow respirations of 7/min, SpO2 86% on oxygen, and rising end-tidal carbon dioxide. Highlight the current assessment findings that demonstrate active opioid-induced ventilatory failure. Do not select baseline risk factors or medication exposure alone.

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Postoperative Record\nA 68-year-old opioid-naive client with obstructive sleep apnea and stage 3 chronic kidney disease is receiving hydromorphone by patient-controlled analgesia and scheduled gabapentin. After therapy begins, the client is difficult to arouse, cannot keep the eyes open, has respirations 7/min and shallow, SpO2 86 percent on 2 L/min oxygen, end-tidal carbon dioxide 58 mm Hg and rising, and pinpoint pupils.
Postoperative Record\nA 68-year-old opioid-naive client with obstructive sleep apnea and stage 3 chronic kidney disease is receiving hydromorphone by patient-controlled analgesia and scheduled gabapentin. After therapy begins, the client is difficult to arouse, cannot keep the eyes open, has respirations 7/min and shallow, SpO2 86 percent on 2 L/min oxygen, end-tidal carbon dioxide 58 mm Hg and rising, and pinpoint pupils.
Explanation
Profound sedation, inability to stay awake, respirations of 7/min, shallow breathing, oxygen saturation of 86 percent despite oxygen, and rising carbon dioxide require immediate rescue.
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