A patient is brought to the emergency department by friends, who report finding the patient difficult to awaken. The friends report removing two fentanyl transdermal patches from the patient's arm
On admission to the emergency department, the patient has pinpoint pupils and a respiratory rate of 6 breaths per minute. A few minutes after administration of naloxone, the respiratory rate is 8 breaths per minute and the patient's pupils are dilated. The nurse recognizes these symptoms as signs of:
a. a mild opioid overdose.
b. decreased opioid drug levels.
c. improved ventilation.
d. worsening hypoxia.
ANS: D
The classic triad of symptoms of opioid overdose are coma, respiratory depression, and pinpoint pupils. The pupils may dilate as hypoxia worsens, and this symptom, along with continued respiratory depression (fewer than 12 breaths per minute), indicates worsening hypoxia. Fentanyl is a strong opioid, so this is not likely to be a mild overdose, because the patient was wearing two patches. Fentanyl continues to be absorbed even after the patches are removed because of residual drug in the skin, so the drug levels are not likely to be decreasing. The patient does not have improved ventilation, because the respiratory rate is still fewer than 12 breaths per minute.
You might also like to view...
Indications for cardiac transplantation include
A) pericarditis. B) end-stage heart disease. C) third-degree heart block. D) uncontrolled ventricular tachycardia.
Pulmonary embolism, a serious complication of HIT, is manifested by which of the following clinical signs?
a. Blanching of fingers and toes and loss of peripheral pulses b. Chest pain, pallor, and confusion c. Headache, impaired speech, and loss of motor function d. Dyspnea, pleuritic pain, and rales
To weigh a newborn, which of the following would be most appropriate?
A) Weighing a dry diaper on the scale to determine its accuracy B) Setting the scale to zero after placing the baby on it C) Covering the platform with a warm blanket before placing the newborn on it D) Washing the platform with a disinfectant solution before placing the newborn on it
Spreading cells from a cytobrush on a slide after a specimen is collected should be done by:
A) Sliding the cytobrush back and forth. B) Using a rolling motion. C) Brushing the specimen on the slide vigorously. D) Lightly dabbing onto the slide.