A. John Medel, 24 years of age, is a male patient who was admitted to the surgical unit after a successful repair of an

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A. John Medel, 24 years of age, is a male patient who was
admitted to the surgical unit after a successful repair of an
inguinal hernia. He is 5 feet 10 inches tall and weighs 120 kg. He
has a neck circumference of 21 inches. The patient has a morphine
PCA. He has no known drug allergies. His vital signs are as
follows: blood pressure 122/70 mm Hg, respiratory rate 26
breaths/min, heart rate 88 bpm, and temperature 98.6°F. The patient
complains of incision pain and rates it on the pain scale as 7 of
10. His family is visiting at the bedside. The nurse administers a
bolus dose of morphine. Fifteen minutes after administering the
pain medication, a family member enters the hallway and yells, “We
need help in here! John is not breathing.” The nurse finds John
having periods of apnea lasting a few seconds followed by a short
snorting gasp and then he begins breathing at a rate of 12 breaths
per minute. His lips are bluish in coloration and so are his nail
beds. The patient is lying supine in the bed. He awakens as the
nurse enters, but is very lethargic and somnolent.