A nurse is caring for a client who is experiencing acute alcohol toxicity. Which of the following actions should the nurse include in the plan?

A. Protective environment. This is incorrect because a protective environment is used for immunocompromised clients, not for those with bacterial meningitis.
B. Droplet. This is correct because bacterial meningitis is transmitted through respiratory secretions. Droplet precautions, including wearing a mask when within 3 to 6 feet of the client, are necessary to prevent the spread of infection.
C. Contact. This is incorrect because bacterial meningitis is not primarily transmitted through direct contact with surfaces or bodily fluids, making contact precautions unnecessary.
D. Airborne. This is incorrect because bacterial meningitis does not spread through airborne particles that remain suspended in the air, so airborne precautions are not required.

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.