What is the first action a nurse should take if a patient on opioids becomes apneic?

• A. Administer the prescribed naloxone (Narcan) by slow IV push.
• B. Call a doctor and wait for orders.
• C. Give the patient water.
• D. Hold all medications and observe.

Answer: (A)

Opioids suppress respiration by acting on brainstem centers that control breathing, so the most urgent move when a patient on opioids becomes apneic is to reverse that effect as quickly as possible. Naloxone is an opioid antagonist that competes for the same receptor sites and displaces the opioid, rapidly restoring ventilatory drive. Giving naloxone by slow IV push allows fast, controlled reversal—you can see the patient’s response and adjust the dose to achieve adequate breathing while minimizing potential risks from a sudden, complete reversal. After administration, continue to monitor respirations, oxygenation, and vital signs, and provide airway support or ventilation as needed. Be aware that naloxone’s duration may be shorter than that of the opioid, so re-dosing or ongoing monitoring is sometimes necessary. If IV access isn’t available, intramuscular or intranasal routes can be used, but IV administration is the quickest and most controllable option in many settings.