A nurse is caring for a client who has opioid use disorder and is experiencing opioid withdrawal. Which of the following findings should the nurse expect?

Introduction: Opioid withdrawal syndrome involves a rebound hyperactivity of the autonomic nervous system that was previously suppressed by chronic opioid use, leading to significant physiological distress and flu-like symptoms. A. Diaphoresis, or profuse sweating, is a common autonomic finding in opioid withdrawal. As the body adjusts to the absence of the drug, the sympathetic nervous system becomes overactive. This is often accompanied by piloerection (goosebumps), which is why the process is sometimes colloquially termed "cold turkey." B. Hypotension is not typical; instead, opioid withdrawal usually causes a mild to moderate increase in blood pressure. The rebound of the sympathetic nervous system increases systemic vascular resistance and heart rate, leading to hypertension rather than a decrease in the client's arterial blood pressure. C. Bradycardia is an effect of opioid intoxication, not withdrawal. During withdrawal, the nurse should expect tachycardia. The heart rate increases as a compensatory mechanism for the autonomic instability and the significant discomfort and anxiety the client experiences during the detoxification process. D. Pinpoint pupils (miosis) are a classic sign of opioid intoxication or overdose. In withdrawal, the nurse should expect mydriasis (dilated pupils). This pupillary dilation is one of the objective markers used in the Clinical Opiate Withdrawal Scale (COWS) to assess the severity of the client's symptoms.