# Place the nursing actions in order for a postoperative client with suspected opioid-induced respiratory depression.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=396410&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

Place the nursing actions in order for a postoperative client with suspected opioid-induced respiratory depression.

Open the airway, provide oxygen, and assist ventilation with a bag-mask device if breathing remains inadequate

Give repeat naloxone doses as prescribed if response is inadequate or respiratory depression returns

Stop the opioid infusion, call for emergency help, and assess responsiveness, airway, breathing, and circulation

Administer the prescribed naloxone dose while continuing ventilatory support and reassessing response

Continue close respiratory and sedation monitoring, manage recurrent pain safely, and document the event and response

## Explanation

Stop further opioid delivery and call for help while assessing ABCs. Support airway and ventilation immediately; oxygen alone does not correct inadequate ventilation. Give prescribed naloxone, repeat it when necessary, and continue surveillance because the opioid effect can outlast naloxone.

## In-depth explanation

Correct sequence
Stop opioid and call for help → open the airway and support ventilation → give naloxone → repeat naloxone if needed → monitor for recurrence and manage pain safely.

Why this is correct
Naloxone reverses opioid respiratory and central nervous system depression, but rescue begins with airway and ventilation. Many opioids act longer than naloxone, so an initial response does not end the emergency.

NCLEX decision rule
Ventilate first, reverse the cause, then watch for renarcotization. Do not leave the client because the respiratory rate briefly improves.References
1FDA naloxone prescribing information
2NCSBN 2026 NCLEX-RN Test Plan

## Clinical scenario

Opioid adverse effect
The client receiving IV opioid analgesia is difficult to arouse, has shallow respirations of 7/min, and has a pulse oximetry reading of 86%. Emergency airway equipment and prescribed naloxone are available.

## Key concepts

- **Opioid-Induced Respiratory Depression** — Inadequate ventilation caused by opioid effects, often accompanied by increasing sedation and slow or shallow breathing.
- **Naloxone** — An opioid antagonist used to reverse opioid-related respiratory and central nervous system depression.
- **Renarcotization** — Return of opioid toxicity after naloxone effect decreases while the opioid remains active.

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