A postoperative patient receiving morphine reports a decreasing respiratory rate of 6 breaths per minute. What is the priority nursing action?

• A. Assess airway and breathing; stop the opioid and prepare to administer naloxone per protocol; call for assistance.
• B. Monitor vital signs and administer additional morphine.
• C. Place the patient in Trendelenburg position.
• D. Continue the current opioid infusion and reassess in 1 hour.

Answer: (A)

Opioid-induced respiratory depression is a life-threatening emergency, so the priority is to protect the airway and restore breathing. When the patient’s rate drops to 6 breaths per minute, immediately assess airway patency and ventilation, stop any further opioid administration, and prepare to administer an opioid antagonist per protocol. Naloxone rapidly reverses opioid effects and can quickly improve respirations, so having it available and calling for assistance are essential steps. After giving naloxone, continue close monitoring and be prepared for possible re-dosing if symptoms recur as the antagonist wears off.

Giving more morphine would worsen the depression and delay recovery. Placing the patient in a Trendelenburg position does not address the respiratory suppression and can impede breathing. Continuing the current opioid infusion and reassessing later would miss a critical window and risk deterioration. Prioritizing airway, breathing, and reversal of the opioid effect ensures the patient’s safety and stability.