A client who is obtunded arrives in the emergency department with a suspected drug overdose. The client becomes responsive after the administration of IV naloxone, but within a short period, the client's level of consciousness decreases again and the respiratory rate decreases to 6 breaths/minute. Which action should the nurse take first?

Administer an additional dose of naloxone.

Initiate a second intravenous access site.

Prepare to initiate cardiopulmonary resuscitation (CPR).

Determine if results of the drug toxicity screen are available.

Answer and Explanation

The Correct Answer is A

A. Administer an additional dose of naloxone: Naloxone has a shorter half-life than many opioids, leading to the recurrence of respiratory depression once its effects wear off. When signs of opioid toxicity return, the immediate priority is to administer another dose of naloxone to reverse life-threatening respiratory depression and restore adequate ventilation.

B. Initiate a second intravenous access site: While maintaining IV access is important in emergency care, establishing a second IV line is not the most urgent priority when the client’s breathing is dangerously slow. Immediate reversal of respiratory depression takes precedence.

C. Prepare to initiate cardiopulmonary resuscitation (CPR): CPR is indicated if the client has no pulse or is not breathing. Since the client is still breathing, although minimally, and has a pulse, the immediate action should be reversing the opioid effects with naloxone, not starting CPR.

D. Determine if results of the drug toxicity screen are available: While knowing the substances involved can guide further treatment, waiting for lab results would delay the critical intervention needed to treat the acute respiratory depression at this moment.

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Free Nursing Study Resources

Correct Answer is ["200"]

Explanation

Identify the total volume to be infused.

Total volume = 100 mL

Identify the infusion time in minutes.

Infusion time = 30 minutes

Convert the infusion time to hours.

Infusion time (hours) = Infusion time (minutes) / 60 minutes/hour

= 30 minutes / 60 minutes/hour

= 0.5 hours

Calculate the infusion rate in mL per hour.

Infusion rate (mL/hour) = Total volume (mL) / Infusion time (hours)

= 100 mL / 0.5 hours

= 200 mL/hour

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B","dropdown-group-3":"A"}

Explanation

Pure opioid agonist: Morphine is classified as a pure opioid agonist because it fully binds and activates opioid receptors, particularly mu receptors, producing maximum analgesic effects for moderate to severe pain management.
Mixed opioid antagonist: Mixed opioid antagonists, like nalbuphine, both activate and block opioid receptors depending on the site. Morphine does not block opioid activity; it purely stimulates, making this choice incorrect.
Non-opioid analgesic: Non-opioid analgesics, such as acetaminophen and NSAIDs, relieve mild to moderate pain without acting on opioid receptors. Morphine’s mechanism and use are specific to the opioid class.
Partial opioid agonist: Partial agonists, such as buprenorphine, activate opioid receptors but produce a weaker response compared to pure agonists. Morphine elicits a full receptor response, differentiating it from partial agonists.
Mu: Mu receptors are the primary opioid receptors activated by morphine, leading to effects such as analgesia, euphoria, respiratory depression, and decreased gastrointestinal motility.
Beta: Beta receptors are adrenergic receptors involved in cardiovascular responses, not pain modulation. Morphine does not interact with beta receptors.
Alpha: Alpha receptors are also part of the adrenergic system and regulate vascular tone and blood pressure. Morphine’s action is not through alpha receptor activation.
Severe pain: Morphine is most commonly used to treat moderate to severe acute or chronic pain, especially postoperative pain, cancer pain, and trauma-related injuries requiring strong opioid therapy.
Hypertension: Morphine is not indicated for treating hypertension. While it may indirectly lower blood pressure due to vasodilation and reduced sympathetic tone, it is not a therapeutic antihypertensive agent.
Depression: Morphine is not used for managing depression. Although it can induce feelings of euphoria, its clinical use is strictly for pain relief, not mood disorders.

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Naxlex Comprehensive Predictor Exams

The nurse mixes diphenhydramine 25 mg in a 100 mL bag of 0.9% sodium chloride, which is to be administered IV over 30 minutes. The IV pump should be set to administer how many mL/hour? (Enter numeric value only.)

Correct Answer is ["200"]

Explanation

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B","dropdown-group-3":"A"}

Explanation

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