A nurse is caring for a client receiving meperidine hydrochloride (Demerol) for pain. Which side effect is the nurse most concerned about?

Meperidine hydrochloride, commonly known as Demerol, is an opioid analgesic used for managing moderate to severe pain. One of the most critical side effects associated with opioid use, including meperidine, is respiratory depression. This occurs because opioids act on the central nervous system to relieve pain, but they also affect the brain's respiratory centers, potentially leading to decreased respiratory rate and depth.

Respiratory depression is particularly concerning in patients who may already be at risk due to underlying health conditions, co-administration of other sedative medications, or increased sensitivity to opioids. The potential for misuse or overdosing of opioids further increases the risk of respiratory depression, making it a priority for nursing assessment and intervention.

While constipation, urinary retention, and hypotension are indeed side effects associated with opioid therapy, they are typically not life-threatening in the same acute manner that respiratory depression can be. Constipation is usually manageable with dietary changes or laxatives, urinary retention can often be treated with bladder schedules or medication adjustments, and hypotension can be monitored and managed with fluid or other supportive measures. In contrast, respiratory depression can lead to hypoxia, brain damage, or even death if not promptly recognized and treated, highlighting why it is the most