A newborn is at risk for opioid exposure due to maternal analgesia during labor. Which medication should the nurse anticipate administering to the newborn?

• A. Naloxone (Narcan).
• B. Nalbuphine (Nubain).
• C. Fentanyl (Sublimaze).
• D. Promethazine (Phenergan).

Answer: (A)

When a newborn is at risk for opioid exposure from maternal analgesia, reversing any opioid-induced respiratory depression is the immediate priority. Naloxone works by acting as a competitive antagonist at mu opioid receptors, displacing opioids and quickly restoring breathing and alertness. In the neonate, you administer naloxone to reverse CNS and respiratory depression, but you must monitor closely because longer-acting opioids from the mother can outlast the naloxone effect, sometimes requiring repeat dosing or a slow infusion. Other options either add more opioid effects (fentanyl), provide analgesia without reversing toxicity (nalbuphine), or are unrelated sedatives (promethazine), so they wouldn’t address opioid-induced respiratory depression. Therefore, naloxone is the appropriate medication to administer to the newborn in this situation.