Narcan Nate — Opioid Overdose & Withdrawal
Pinpoint pupils, RR 6, unresponsive — naloxone now, then watch for it to wear off first
Nate is found slumped in a bathroom, lips blue, barely breathing three times a minute. An hour after being revived and stabilizing, his overdose symptoms suddenly return.
Nate is found unresponsive with a respiratory rate of 6 and pinpoint pupils after opioid use. Naloxone reverses the overdose but has a shorter half-life than most opioids, so repeated doses and close monitoring are needed as it wears off. Separately, opioid withdrawal is intensely uncomfortable — yawning, rhinorrhea, diarrhea, piloerection, muscle aches — but unlike alcohol withdrawal, it is not life-threatening.
Read Narcan Nate's full story →The story arc
The setup
Nate has used opioids daily for two years and injected an unknown amount an hour before being found.
The turn
He is found unresponsive, respirations at 6 per minute, pupils pinpoint, and his lips are dusky blue.
The crisis
Forty-five minutes after naloxone reverses him, Nate becomes drowsy again with respirations dropping to 8 per minute.
The save
The nurse gives a repeat dose of naloxone, keeps him on continuous monitoring for hours, and prepares to support him through the withdrawal that naloxone can trigger.
NCLEX study section — Opioid Overdose & Withdrawal
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Mental Health
Take this chapter into practice questions on the same topic.