The nurse administers meperidine to a laboring client, who delivers 90 minutes later. What medication should the nurse anticipate administering to the infant?

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

Answer: (A)

Opioids given to a laboring patient can cross to the fetus and depress the newborn’s breathing after birth. If the baby shows signs of respiratory depression or poor responsiveness because of maternal meperidine, an opioid antagonist is used to rapidly reverse those effects. Naloxone works by binding to opioid receptors more strongly than the opioid does, displacing it and restoring respiration in the neonate. So, preparing to administer naloxone to the infant when respiratory depression is present helps counteract the opioid effect from the mother’s analgesia.

The other options won’t achieve that reversal. An opioid like fentanyl would worsen respiratory depression rather than reverse it. Nalbuphine is an opioid agonist-antagonist and doesn’t serve as an antidote to opioid-induced depression. Promethazine is an antiemetic/sedative with no role in reversing neonatal opioid effects.