Question

A client with esophageal cancer returns to the endoscopy recovery area after an esophogastroduodenoscopy (EGD) was performed via conscious sedation with midazolam (Versed). Assessment reveals an O2 saturation of 85%, respirations 8, and nonresponsiveness. The nurse prepares to administer which of the following drugs? ? A. Flumazenil (Romazicon) ? B. Chlorpromazine (Thorazine) ? C. Methylphenidate (Ritalin) ? D. Epinephrine (Epifrin)

Short answer

Answer: A. Flumazenil (Romazicon)

Step-by-step solution

1. Evaluate the client's symptoms

The patient presents with low O2 saturation (85%), decreased respirations (8), and nonresponsiveness after undergoing an EGD with conscious sedation. These symptoms suggest that the patient may be experiencing an adverse reaction to the sedative medication used during the procedure. The goal is to identify a drug that will effectively reverse the effects of the administered sedation and improve the patient's condition.

2. Assess the medication options

The nurse is provided with four possible medications to administer: A. Flumazenil (Romazicon) B. Chlorpromazine (Thorazine) C. Methylphenidate (Ritalin) D. Epinephrine (Epifrin) Let's examine the indications and contraindications for each drug.

3. Flumazenil (Romazicon)

Flumazenil (Romazicon) is a benzodiazepine antagonist and is specifically used to reverse the effects of benzodiazepine sedation, such as midazolam (Versed), which was used in this case. It can help reverse the symptoms of respiratory depression and sedation that the patient is currently experiencing.

4. Chlorpromazine (Thorazine)

Chlorpromazine (Thorazine) is an antipsychotic medication used to treat various psychiatric disorders. It is not indicated for the reversal of sedation or for improving oxygen saturation or respiration.

5. Methylphenidate (Ritalin)

Methylphenidate (Ritalin) is a stimulant most commonly prescribed for attention deficit hyperactivity disorder (ADHD). It is not suitable for counteracting sedative effects or improving oxygen saturation and respiration.

6. Epinephrine (Epifrin)

Epinephrine (Epifrin) is a medication used to treat severe allergic reactions (anaphylaxis) and cardiac arrest. It is not recommended for reversing sedative effects or for improving oxygen saturation and respiration in this context.

7. Select the appropriate medication

From the analysis of each drug, it is clear that Flumazenil (Romazicon) is the most appropriate choice for this situation, as it is specifically designed to reverse the effects of benzodiazepine sedation (midazolam) and can help improve the patient's symptoms. Therefore, the nurse should prepare to administer Flumazenil (Romazicon). The correct answer is A. Flumazenil (Romazicon).