A nurse is caring for a client who is experiencing status epilepticus. Which of the following medications should the nurse expect to administer?

Miosis : Pinpoint pupils are a hallmark of opioid overdose due to stimulation of the parasympathetic nervous system. This finding helps distinguish opioid toxicity from other types of substance use, which often cause pupil dilation instead.

Respiratory depression : Opioids depress the medullary respiratory centers in the brainstem, leading to slowed breathing. A respiratory rate of 10/min is significantly reduced and signals impaired ventilation, making it a critical diagnostic clue.

Opioid overdose: The clinical signs—needle marks, sedation, pinpoint pupils, bradypnea, and a positive response to naloxone—all strongly point to an opioid overdose. A similar prior episode adds to the likelihood of chronic opioid misuse.

Alcohol intoxication: While alcohol can depress the central nervous system, it does not typically cause miosis or respond to naloxone. Also, the pattern of rapid reversal with naloxone suggests opioid involvement rather than alcohol alone.

Benzodiazepine overdose: Though it shares features like sedation and respiratory depression with opioid overdose, benzodiazepine toxicity does not cause miosis, and naloxone has limited or no effectiveness as a reversal agent.

Cocaine intoxication : Typically causes stimulant effects including mydriasis (dilated pupils), increased heart rate, hypertension, and agitation. These are not consistent with the symptoms in this case, which reflect CNS depression.

A. Apply splints to the child's extremities during the day. Splints are typically used at night to help prevent joint contractures and support proper alignment during rest. Daytime use may limit mobility and physical activity, which are encouraged.
B. Encourage the child to take naps during the day. While rest is important, excessive daytime napping can contribute to joint stiffness and reduced function. Activity and movement are encouraged to maintain joint flexibility.
C. Have the child take a tub bath each morning. Warm baths help relieve joint stiffness and pain associated with juvenile idiopathic arthritis. Morning bathing is especially beneficial to improve mobility at the start of the day.
D. Keep the child on bedrest as long as pain persists. Prolonged bedrest can lead to muscle atrophy, stiffness, and joint contractures. Maintaining activity, as tolerated, is key to managing symptoms and preserving joint function.