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Analgesics - Priority Sheet
Opioid Overdose Naloxone NCLEX Priority Sheet
Opioid overdose questions test airway and breathing first, respiratory depression, naloxone response, reassessment, repeat sedation risk, and emergency follow-up.
Study aid - not medical advice. Not a clinical decision tool. For NCLEX pharmacology review only.
Priority 1
What to do first
1. Assess airway, breathing, respiratory rate, oxygen saturation, and level of consciousness.
2. Support ventilation and call for help per emergency protocol.
3. Administer naloxone as ordered or per protocol for suspected opioid-induced respiratory/CNS depression.
Safety
Hold If
Hold further opioid doses per protocol and notify the provider for RR <12/min, difficult arousal, oxygen desaturation, apnea, severe sedation, hypotension, or repeated need for naloxone.
Do not leave after the patient wakes up. Continue monitoring because opioid effects can outlast naloxone.
Monitoring
Labs to Watch
This is mainly an assessment-and-vitals topic: RR, SpO2, EtCO2 if available, BP, pulse, sedation score, pain score, and mental status.
ABGs, tox testing, glucose, or other labs may be ordered depending on context.
Review Details
NCLEX Review Notes
Key Signs
Classic triad: respiratory depression, decreased level of consciousness, and pinpoint pupils.
Priority: breathing matters more than simply waking the patient. Maintain airway and ventilation support per emergency protocol.
NCLEX Trap
Trap: the patient wakes up after naloxone, so the nurse stops monitoring.
Safer answer: keep monitoring. Naloxone duration can be shorter than some opioids, so respiratory depression can return.
Related Pattern
Opioid adverse effects: respiratory depression, sedation, constipation, nausea, urinary retention, hypotension, and fall risk.
Naloxone effect: can precipitate withdrawal and acute pain return; monitor agitation, vomiting, tachycardia, and recurrent sedation.
Mini Quiz
Question: A post-op patient receiving morphine is difficult to arouse, RR 7/min, SpO2 86%. What should the nurse do first?
Answer: support airway/breathing, call for help, hold opioid per protocol, and administer naloxone as ordered or per protocol.
References
Saunders Comprehensive Review for the NCLEX-RN Examination; Davis's Drug Guide for Nurses; DailyMed naloxone hydrochloride labeling; emergency opioid overdose response guidance.
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