A nurse is providing nutritional teaching to the guardian of a 12.month.old toddler. Which of the following information should the nurse include?

Rationale for correct choices:

• Opioid intoxication: The client was found unresponsive with a needle in the antecubital space, had pinpoint pupils, and responded to naloxone—all classic signs of opioid overdose. Vital signs showing bradycardia and hypoventilation support CNS depression consistent with opioid toxicity.
• Pupil characteristic: Pinpoint pupils (miosis) are a hallmark of opioid intoxication and help distinguish it from other conditions like withdrawal or alcohol-related disorders. This ocular finding, combined with sedation and history of IV drug use, makes it a key diagnostic indicator.

Rationale for incorrect choices:

• Alcohol withdrawal: Withdrawal from alcohol typically presents with symptoms like tremors, agitation, anxiety, tachycardia, and possibly seizures or hallucinations—not pinpoint pupils or decreased responsiveness. The client does not show these signs.
• Opioid withdrawal: The previous hospitalization showed opioid withdrawal symptoms at 1000 (mydriasis, hyperreflexia, diaphoresis, piloerection) after receiving buprenorphine/naloxone. The current symptoms are not consistent with withdrawal.Today’s sedation and miosis indicate overdose, not withdrawal.
• Alcohol intoxication|: While alcohol intoxication can cause sedation and decreased coordination, it does not cause miosis. The ingestion of one beer, as reported, would not account for unconsciousness and respiratory depression, and naloxone would not reverse alcohol effects.
• Current temperature: The client’s temperature is within normal range and not specific to any of the listed conditions. It offers no diagnostic value in distinguishing between opioid use, withdrawal, or alcohol-related issues.
• Amount of alcohol consumed: The report of one beer is not enough to support alcohol intoxication, especially with the severity of the symptoms. The more pressing concern is the needle mark and opioid-related signs.
• Breath sounds: Breath sounds are clear and equal, which does not support or oppose any of the listed conditions. While important in ruling out aspiration or pulmonary issues, they do not guide the diagnosis here.

A. Sit next to the client when speaking to them: Sitting in front of the client is more effective, as it allows the client to see the nurse’s facial expressions and lip movements, which can aid comprehension.
B. Lower the tone of voice at the end of each sentence: Lowering tone may make speech harder to hear. Many people with hearing loss have difficulty hearing low-pitched sounds, so lowering the tone can reduce clarity.
C. Emphasize vowel sounds when speaking: Vowel sounds are softer and less distinct than consonants. Emphasizing consonants and speaking clearly at a moderate pace is more effective than focusing on vowels.
D. Decrease background noise when talking with the client: Reducing background noise enhances the client's ability to hear and understand by minimizing auditory distractions, making this the most helpful communication strategy.