A nurse is assisting with the care of a client who is verbalizing their desire for natural family planning as a method of contraception. Which of the following responses should the nurse make?

• alcohol intoxication: Although the client consumed one beer, this small amount is unlikely to cause unresponsiveness, respiratory depression, or the need for naloxone administration. Alcohol intoxication alone does not explain the profound sedation and pinpoint pupils observed.
• alcohol withdrawal: Alcohol withdrawal typically presents with signs like agitation, tremors, hallucinations, and seizures, not sedation, miosis, and depressed respiratory drive. The client’s symptoms are inconsistent with alcohol withdrawal.
• hallucinogen intoxication: Hallucinogen use usually leads to agitation, paranoia, hallucinations, and dilated pupils (mydriasis), not the sedated state, respiratory depression, and miotic pupils that this client is exhibiting.
• opioid intoxication: The client's unresponsiveness, respiratory depression, and pinpoint pupils, combined with a positive response to naloxone, are classic indicators of opioid intoxication. These findings directly align with the expected effects of opioid overdose.
• opioid withdrawal: Opioid withdrawal presents with signs like agitation, mydriasis, diarrhea, piloerection, and flu-like symptoms. The client’s current state of sedation and miotic pupils contradicts what would be seen during opioid withdrawal.
• amount of alcohol consumed: The small amount of alcohol (one beer) does not correlate with the severity of the client’s clinical presentation. Thus, alcohol consumption is not the primary factor contributing to the current state.
• breath sounds: Breath sounds are clear and equal bilaterally, indicating that the lungs are not the source of the client's critical condition. There is no evidence of respiratory infection or pulmonary complications.
• abdominal findings: Decreased bowel sounds are common in opioid intoxication due to decreased gastrointestinal motility. However, while supportive, this finding is less definitive than the hallmark sign of pupil constriction.
• pupil characteristics: The presence of pinpoint pupils (miosis) is a hallmark sign of opioid intoxication. Miotic pupils, especially in an unresponsive client who improved after naloxone, strongly support opioid overdose as the primary diagnosis.
• current temperature: The client's temperature is within normal limits, providing no significant diagnostic clue toward explaining the cause of unresponsiveness or respiratory depression.

A. Leg cramps: Leg cramps are a common and expected discomfort during the later stages of pregnancy. They usually result from changes in circulation, pressure from the growing uterus, or altered calcium and magnesium levels.

B. Blurred vision: Blurred vision is a concerning finding in pregnancy as it can be a sign of preeclampsia, a serious hypertensive disorder that poses risks to both the mother and fetus. It requires immediate evaluation by the provider.

C. Urinary frequency: Urinary frequency is a common symptom in late pregnancy due to the pressure of the enlarging uterus on the bladder. It is typically expected unless accompanied by signs of infection.

D. Gingivitis: Gingivitis can occur during pregnancy due to hormonal changes that affect gum tissue. While it should be managed with good oral hygiene, it is not an urgent concern requiring immediate reporting.