# A client wearing a buprenorphine patch used a heating pad over the site and is now difficult to arouse with respirations of 9/min. Which action is the priority?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522098&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client wearing a buprenorphine patch used a heating pad over the site and is now difficult to arouse with respirations of 9/min. Which action is the priority?

## Option

1. Remove the heat source, support ventilation, summon emergency help, and prepare authorized reversal. **✔ Correct answer**
2. Keep the heating pad in place, reposition the client, and wait for the patch level to stabilize.
3. Apply a second patch away from the heated site to prevent pain and withdrawal during assessment.
4. Cover the existing patch with a warming wrap and postpone reassessment until the next medication round.

**Correct answer: 1**

## Explanation

External heat can increase transdermal buprenorphine absorption and cause overdose and death; current sedation and bradypnea require emergency opioid-rescue actions.

## In-depth explanation

Quick answer
Stop heat-enhanced opioid delivery and rescue ventilation.

Why this is correct
The label warns against heating pads, hot tubs, saunas, and prolonged heat exposure because temperature-dependent release can produce overdose.

Easy analogy or mental picture
Treat medication safety like airway triage: identify the threat, interrupt exposure, support physiology, and verify a durable response.

Memory hook
Cue, risk, action, response, recurrence check.

NCLEX decision rule
Choose the action that prevents the most immediate medication-related harm while preserving reassessment and escalation.

Why the other choices are wrong
Options that normalize deterioration, add interacting medication, or delay rescue leave the safety loop open.References
1DailyMed: BUTRANS (buprenorphine transdermal system)External heat increases absorption and can cause overdose, respiratory depression, and death

## Clinical scenario

Medication safety review
Verify the indication, current assessment, respiratory and neurologic status, interactions, authorized rescue action, and measurable follow-up.

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