A client develops severe respiratory depression after an intravenous opioid. Complete the immediate reversal and monitoring plan.
Drop-down Cloze
Choose your responses, then check the answer.
Explanation
A respiratory rate of 6/min with shallow breathing, hypoxemia, and decreased responsiveness is a life-threatening opioid effect. The nurse stops ongoing opioid delivery, calls for help, opens and supports the airway, and provides oxygen and ventilation as needed while naloxone is administered according to protocol or prescription. Because naloxone may wear off before the opioid, improvement is not the end of care; the client needs continued respiratory and neurologic surveillance and repeat naloxone if depression recurs.
Correct Answer Stop opioid delivery, support airway and ventilation, administer naloxone, and continue surveillance for recurrent depression.
Why It Fits The client has severe central nervous system and respiratory depression shortly after intravenous opioid administration.
Clinical Picture Naloxone can reverse opioid effects rapidly, but its duration may be shorter than that of the opioid.
Memory Link Reverse, ventilate, and remain vigilant.
NCLEX Rule Naloxone does not replace airway and ventilation support, and response must be monitored for recurrence.
Why the Alternatives Fail Waiting for oxygen alone, leaving the opioid connected, or stopping observation after initial arousal risks preventable hypoxic injury and renarcotization.
Sources
1FDA Naloxone Prescribing Information
2NCSBN 2026 NCLEX-RN Test Plan
Postoperative unitTwenty minutes after intravenous hydromorphone, the client is difficult to arouse. Respiratory rate is 6/min, oxygen saturation is 83%, and respirations are shallow. The opioid infusion is still connected. Naloxone and ventilation equipment are immediately available.
Opioid-induced respiratory depression — Reduced respiratory drive and ventilation caused by opioid effects on the central nervous system.
Naloxone — An opioid antagonist used to reverse life-threatening opioid effects.
Recurrent respiratory depression — Return of opioid toxicity after naloxone effect diminishes while the opioid remains active.