# A client develops severe respiratory depression after an intravenous opioid. Complete the immediate reversal and monitoring plan.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=546627&lang=en  
> language: en  
> subject: Pharmacological Pain Management  
> category: PPT

## Question

A client develops severe respiratory depression after an intravenous opioid. Complete the immediate reversal and monitoring plan.

The nurse first ::선택::place the client flat and waitincrease the opioid for pain controlstop opioid delivery, call for help, and support the airwayoffer oral fluids, then ::선택::delay treatment until a blood gas returnsadminister a sedativereconnect the opioid infusionadminister naloxone according to protocol or prescription. While reversal is occurring, the nurse should ::선택::provide oxygen and assisted ventilation as neededleave the client alone to reduce stimulationrestrict oxygen until naloxone worksfocus only on the pain score. After improvement, the nurse must ::선택::end observation once the client opens the eyescontinue surveillance and repeat naloxone if respiratory depression recursresume the same opioid dose immediatelytransfer without communicating the event.

## 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.

## In-depth explanation

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

## Clinical scenario

Postoperative unit
Twenty 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.

## Key concepts

- **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.

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