The nurse administers naloxone to a young adult client who overdosed on hydromorphone. Which assessment data indicates that the naloxone is effective?

Rationale: A. Babinski reflex changes from negative to positive: The Babinski reflex is a neurological assessment finding. Naloxone’s purpose is to reverse opioid-induced respiratory and central nervous system depression, not to alter reflex pathways. B. Pupil size increases from 4 mm to 6 mm: While opioid overdose often causes pinpoint pupils, naloxone’s primary therapeutic goal is not pupillary change. A slight increase in pupil size may occur, but it is not the most reliable or critical indicator of naloxone effectiveness. C. Blood pressure decreases from 140/94 mm Hg to 120/78 mm Hg: Blood pressure changes can happen during opioid reversal but are not the most direct indicator. The nurse’s focus should remain on improved ventilation and oxygenation rather than moderate changes in vital signs. D. Respirations increase from 8 breaths/minute to 12 breaths/minute: The most important and direct evidence that naloxone is effective is the restoration of adequate respirations. Since opioids depress respiratory drive, an increase in respiratory rate and effort reflects successful reversal of opioid toxicity.