The nurse administers naloxone to a patient with opioid-induced respiratory depression. An hour later, the nurse finds the patient has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unresponsive. What action should the nurse take?

The patient’s respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and unresponsiveness indicate severe respiratory depression and a life-threatening emergency. Naloxone was administered an hour ago, but its effects typically last 30–90 minutes, and opioid effects may outlast it, especially with long-acting opioids. The priority is to address the immediate threat to life. A. Administer a second dose of naloxone: Naloxone reverses opioid-induced respiratory depression. Given the recurrence of severe symptoms, a repeat dose is appropriate to counteract potential ongoing opioid effects. B. Prepare to assist with chest tube insertion: This is irrelevant, as there’s no indication of pneumothorax or other conditions requiring a chest tube. C. Determine Glasgow Coma Scale score: While assessing neurological status is useful, it’s not the priority when the patient is in acute respiratory failure. D. Initiate cardiopulmonary resuscitation (CPR): CPR is indicated for cardiac arrest, but the patient has a respiratory rate (albeit critically low) and no mention of absent pulse, so CPR is not yet warranted. The most appropriate action is to administer a second dose of naloxone to reverse the opioid-induced respiratory depression, followed by close monitoring and supportive care (e.g., oxygen, ventilation support if needed). Final Answer: A. Administer a second dose of naloxone.