What should a nurse do when a client on a high-dose Demerol regimen shows signs of confusion and hallucinations?

When a client on a high-dose Demerol regimen exhibits signs of confusion and hallucinations, the appropriate response involves assessing and addressing possible adverse effects of the medication. In this situation, decreasing the Demerol infusion rate is a prudent action because such symptoms can be indicative of opioid toxicity or an adverse reaction to the medication. High doses of Demerol can lead to neurological effects including confusion and hallucinations due to its central nervous system depressant properties.

By reducing the infusion rate, the nurse can help mitigate these side effects, allowing for safer management of the client's pain while minimizing the risk of further complications. This action reflects an understanding of pharmacological principles and a focus on patient safety and comfort.

In contrast, administering a PRN dose of Demerol may exacerbate the confusion and hallucinations, as it would increase the overall opioid exposure. Administering naloxone might be appropriate in cases of suspected overdose, but it is not the immediate step that addresses the direct issue of confusion and hallucinations linked to the Demerol itself. Notifying the healthcare provider is important, but the nurse can take initial action to address the symptoms before escalating concerns to the provider.