امرأة عمرها ٧٤ سنة بعد عملية استبدال الورك، تأخذ مورفين بالمضخة التي يتحكم بها المريض، وابنتها كانت تضغط الزر لها وهي نائمة. الآن هي نعسانة جداً، وتنفسها ٨ في الدقيقة، وتشبعها ٨٩٪، وحدقتاها صغيرتان. ما أول إجراء؟

A 74-year-old woman after hip replacement has patient-controlled morphine analgesia, and her daughter has been pressing the button while she slept. She is now very drowsy, RR 8, SpO2 89%, with pinpoint pupils. What is the first action?

1. Increase morphine because pain is suppressing breathing
2. Give oxygen and let him sleep because he is tired
3. Stop the pump and rouse the client, prompting him to breathe
4. Raise his legs, give fast fluids, then reassess

Answer: C) Stop the pump and rouse the client, prompting him to breathe. Drowsiness and slow breathing indicate opioid respiratory depression. Stop the drug, stimulate the client, give oxygen and prepare naloxone as ordered with continuous monitoring.