The nurse in the Emergency Department (ED) assesses a 17-year-old patient with blue-tinged lips, slowed respirations, and pinpoint pupils. The patient has no response to painful stimuli. Which of the following should be the nurse’s priority action?

The correct answer is a. I feel so defeated and want to hide after I have binged.

Choice A Reason:

Individuals with binge-eating disorder often experience intense feelings of shame, guilt, and defeat after a binge episode. This emotional response is a hallmark of the disorder and can lead to further cycles of binge eating as a way to cope with these negative emotions. The statement “I feel so defeated and want to hide after I have binged” accurately reflects the emotional turmoil that accompanies binge-eating episodes.

Choice B Reason:

The statement “I am able to control the pace of my bingeing when I start getting full” is not typically associated with binge-eating disorder. People with this disorder often feel a loss of control over their eating during a binge episode and are unable to stop even when they are full. This lack of control is a key diagnostic criterion for binge-eating disorder.

Choice C Reason:

While feeling hungry can trigger a binge, it is not the primary characteristic of binge-eating disorder. The disorder is more about the uncontrollable nature of the eating episodes and the emotional distress that follows, rather than just responding to hunger. Therefore, the statement “My binges usually start off with feeling hungry” does not fully capture the essence of the disorder.

Choice D Reason:

Binge-eating as a reward for completing difficult tasks is not a typical feature of binge-eating disorder. The disorder is more about using food as a way to cope with negative emotions rather than as a reward. The statement “I binge to reward myself for completing difficult tasks” does not align with the common emotional triggers for binge-eating episodes.

The correct answer is b. Administer oxygen via 100% nonrebreather and place an IV catheter to give naloxone.

Choice A Reason: Get the defibrillator to the patient’s bedside and open the crash cart

While having the defibrillator and crash cart ready is important in emergency situations, it is not the immediate priority in this scenario. The patient’s symptoms suggest opioid overdose, which requires immediate intervention to support breathing and reverse the effects of the opioid. The primary focus should be on ensuring adequate oxygenation and administering naloxone.

Choice B Reason: Administer oxygen via 100% nonrebreather and place an IV catheter to give naloxone

This is the correct answer. The patient’s blue-tinged lips, slowed respirations, and pinpoint pupils are indicative of opioid overdose. Administering oxygen via a 100% nonrebreather mask helps to ensure adequate oxygenation, while placing an IV catheter allows for the administration of naloxone, an opioid antagonist that can reverse the effects of the overdose. This intervention addresses the immediate life-threatening condition.

Choice C Reason: Administer naloxone intranasally if there is not an IV catheter in place

While administering naloxone intranasally is an appropriate alternative if IV access is not available, it is not the first priority. The initial focus should be on ensuring adequate oxygenation and establishing IV access for more effective administration of naloxone. If IV access cannot be quickly established, then intranasal naloxone can be used.

Choice D Reason: Contact the patient’s parents or legal guardian for consent to treat

Obtaining consent is important, but it is not the immediate priority in a life-threatening situation. The nurse’s primary responsibility is to stabilize the patient and address the acute medical emergency. Once the patient is stabilized, the nurse can then contact the parents or legal guardian for further consent and information.