The 48-year-old patient is brought via ambulance to the emergency room after being found unresponsive by her son. She has a prescription for transdermal fentanyl patches for treatment of cancer pain related to her breast cancer that has metastasized to her pelvis. The patient’s heart rate is 72 bpm, respiratory rate is 4 breaths per minute, and her oxygen saturation is 88%. Her arterial blood gas results are: pH 7.21, PaCO₂ 72 mmHg, PaO₂ 74, HCO₃¯ 23. A thorough assessment reveals 2 fentanyl patches on the patient’s skin. The nurse advocates for which initial action?

Question

The 48-year-old patient is brought via ambulance to the emergency room after being found unresponsive by her son. She has a prescription for transdermal fentanyl patches for treatment of cancer pain related to her breast cancer that has metastasized to her pelvis. The patient&rsquo;s heart rate is 72 bpm, respiratory rate is 4 breaths per minute, and her oxygen saturation is 88%. Her arterial blood gas results are: pH 7.21, PaCO₂ 72 mmHg, PaO₂ 74, HCO₃&macr; 23. A thorough assessment reveals 2 fentanyl patches on the patient&rsquo;s skin. The nurse advocates for which initial action?

Accepted Answer

Intravenous naloxone. The patient has an acute uncompensated respiratory acidosis related to bradypnea due to fentanyl overdose. The initial treatment is intravenous naloxone to reverse the narcotic overdose. The patient may require rapid sequence intubation, but an attempt should be made to reverse the overdose. Bilevel positive airway pressure is not helpful to this patient. Intravenous epinephrine is not indicated in this patient who has an adequate heart rate and blood pressure.

Want help? View the answer with rationale.

Rationale

Additional Physiological Adaptation Questions

Nursing Careers

Nursing Degrees

NCLEX