A nurse is assessing a client who has a calcium level of 7.6 mg/dL. Which of the following findings should the nurse expect?

Potential Condition: Opioid intoxication

Actions to Take:

1. Obtain a prescription for naloxone
2. Prepare to initiate mechanical ventilation

Parameters to Monitor:

1. Pupillary reaction,
2. Respiratory rate

Rationale:

• Potential Condition: The client presents with shallow breathing, slurred speech, confusion, pupillary constriction, and bradycardia, which are classic signs of opioid intoxication. The history of back pain also suggests possible opioid use.
• Actions to Take:
  • Naloxone is an opioid antagonist that can rapidly reverse respiratory depression caused by opioid overdose.
  • Mechanical ventilation may be necessary if respiratory depression is severe and does not improve with naloxone administration.
• Parameters to Monitor:
  • Pupillary reaction is important because opioids cause pupillary constriction (miosis). Improvement in pupillary size and reaction indicates the opioid effects are wearing off.
  • Respiratory rate should be closely monitored since opioid overdose primarily affects respiratory drive, leading to hypoxia and potential respiratory failure.

A. Asking "Why do you think that alternative therapies are a better choice?" may come across as judgmental or challenging the client’s decision rather than supporting it. This is not therapeutic.
B. "You should consult with your family before seeking other treatments." assumes that the client’s decision depends on their family, which disregards autonomy.
C. "What has your doctor told you about your treatment options?" is an open-ended question that allows the client to express concerns while ensuring they have the necessary information to make an informed decision. This is the best response.
D. "I will come back to talk to you about your decision when you feel better." invalidates the client’s feelings and delays an important discussion.