# 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.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=396098&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

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.

The nurse should first ::선택::wait 30 minutes for spontaneous improvementstop further opioid delivery, call for emergency help, and support airway and ventilationplace the client alone in a dark roomaddress bowel elimination before breathing, then ::선택::administer naloxone according to the order or emergency protocol while ventilation is supportedgive an additional sedativeresume the opioid infusion when the client briefly opens the eyeswithhold oxygen until the medication response is known, and ::선택::end monitoring immediately after the first responsetransfer responsibility without communicating the eventcontinue respiratory and neurologic surveillance and prepare for recurrent depression and additional treatmentencourage unassisted ambulation.

## 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.

## In-depth explanation

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

## Clinical scenario

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.

## Key concepts

- **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.

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