medium · NCLEX-RN basic-care
The registered nurse is caring for a 67-year-old male postoperative client who developed severe opioid-induced ventilatory depression while on a hydromorphone patient-controlled analgesia (PCA) pump. After holding the PCA, the nurse successfully administered 0.1 mg of intravenous naloxone, resulting in an increase in respiratory rate from 6 to 14 breaths/minute and an improvement in arousal.
Which pharmacokinetic mechanism must guide the nurse's subsequent surveillance plan?
- Naloxone must be co-administered with a continuous crystalloid infusion to accelerate renal excretion of the active opioid.
- Naloxone permanently binds to mu-opioid receptors, which completely eliminates the risk of recurrent sedation, in this situation.
- The half-life of naloxone is much shorter than that of hydromorphone, requiring continuous respiratory assessment for re-sedation.
- Naloxone has a longer half-life than hydromorphone, making recurrent respiratory depression highly unlikely.
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