A nurse is planning care for a client who is experiencing opioid toxicity. Which of the following medications should the nurse anticipate administering?

B) Melena: Melena refers to black, tarry stools and is indicative of upper gastrointestinal bleeding. Warfarin is an anticoagulant medication that works by inhibiting the synthesis of vitamin K-dependent clotting factors, thereby prolonging the time it takes for blood to clot. While anticoagulation is intended to prevent thrombosis, it also increases the risk of bleeding, including gastrointestinal bleeding. Melena is a concerning sign of significant bleeding and requires prompt medical attention. The nurse should prioritize reporting melena to the provider to facilitate further evaluation and management, which may include adjusting the warfarin dosage or investigating the underlying cause of the bleeding.

A) Hair loss: Hair loss, or alopecia, is a known side effect of warfarin but is generally not considered a priority finding compared to signs of active bleeding. While hair loss can be distressing for clients, it is typically not life-threatening and may resolve spontaneously or with discontinuation of the medication.

C) Abdominal cramping: Abdominal cramping can occur for various reasons, including gastrointestinal upset or other gastrointestinal issues, but it is not typically associated with warfarin use. While the nurse should assess and address the client's abdominal cramping, it is not as urgent as reporting signs of active bleeding such as melena.

D) Fever: Fever may indicate the presence of an infection or inflammatory process but is not directly related to warfarin therapy. However, if the fever is accompanied by signs of bleeding or other concerning symptoms, it should be reported to the provider for further evaluation. Nonetheless, in the absence of other significant symptoms, fever alone may not be as urgent as reporting melena, which suggests active bleeding.

A) Naloxone: This is the correct medication to anticipate administering for opioid toxicity. Naloxone is an opioid antagonist that competitively blocks opioid receptors, reversing the effects of opioid overdose, including respiratory depression, sedation, and hypotension. Administering naloxone can quickly reverse the toxic effects of opioids and restore adequate ventilation and consciousness in the client.

B) Atropine: Atropine is not indicated for opioid toxicity. It is an anticholinergic medication used to treat bradycardia and to decrease respiratory secretions, but it does not reverse the effects of opioids.

C) Midazolam: Midazolam is a benzodiazepine medication used for sedation, anxiety reduction, and induction of anesthesia. While it may be used as an adjunct in the management of acute agitation or seizures, it is not the primary medication for reversing opioid toxicity.

D) Dexamethasone: Dexamethasone is a corticosteroid medication with anti-inflammatory and immunosuppressive effects. It is not indicated for the treatment of opioid toxicity.