2. Nurse Thompson is attending to Maria, a pregnant patient in labor who has been administered an opioid analgesic for pain management. To ensure safety, Nurse Thompson must be prepared for any potential respiratory depression. Which medication should Nurse Thompson have ready for immediate use?
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EXPLANATION
✔Correct answer:
B) Naloxone (Narcan). Naloxone is an opioid antagonist that is used to counteract the effects of opioid overdose, including severe respiratory depression. It works by binding to opioid receptors with a higher affinity than opioid agonists (like morphine or oxycodone), thereby displacing the opioid molecules and reversing their effects. This makes naloxone the ideal medication to have on hand for immediate use if Maria experiences opioid-induced respiratory depression during labor.
Think of naloxone as a "reset button" for the effects of opioids. Just as a reset button stops a device from malfunctioning and brings it back to its normal state, naloxone quickly reverses the dangerous effects of opioids and restores normal breathing.
Naloxone works by competitively binding to the same receptors in the brain that opioids bind to, specifically the mu, kappa, and delta opioid receptors. Because naloxone has a higher affinity for these receptors than most opioids, it can effectively displace the opioid molecules. The onset of action for naloxone is rapid, typically within 2 to 5 minutes when administered intravenously, and slightly longer when administered via intramuscular or subcutaneous routes. The half-life of naloxone is relatively short, about 30 to 81 minutes, which means that in some cases, multiple doses may be necessary to fully reverse opioid effects, especially with long-acting opioids.
✘Incorrect answer options:
Oxycodone (Oxycontin). Oxycodone is an opioid analgesic, not an opioid antagonist. Administering oxycodone would not help in cases of opioid-induced respiratory depression; in fact, it could worsen the situation by adding more opioid to the system, thereby increasing the risk of respiratory depression.
Morphine sulfate. Morphine is another opioid analgesic, similar to oxycodone. Like oxycodone, morphine would exacerbate opioid-induced respiratory depression rather than alleviate it. Therefore, it is not suitable for reversing the effects of an opioid overdose.
Meperidine hydrochloride (Demerol). Meperidine is also an opioid analgesic, and its use in this context would be inappropriate. Meperidine can cause respiratory depression similar to other opioids and would not counteract opioid-induced respiratory depression.
References
- Lehne, R. A., & Rosenthal, L. D. (2019). Pharmacology for Nursing Care (10th ed.). Elsevier.
- Kee, J. L., Hayes, E. R., & McCuistion, L. E. (2018). Pharmacology: A Patient-Centered Nursing Process Approach (9th ed.). Saunders.