A client is prescribed an opioid for post-operative pain. Which assessment is the highest priority before and after administration?

OPIOID SAFETY — RESPIRATORY DEPRESSION: The most dangerous opioid adverse effect is respiratory depression — opioids suppress the brainstem respiratory drive. PRIORITY ASSESSMENTS: Respiratory rate (hold and notify if < 12/min in adults); Sedation level (use a sedation scale — increasing sedation precedes respiratory depression); oxygen saturation; ASSESS BEFORE: Establish baseline RR and sedation; ASSESS AFTER: Peak effect timing — IV opioids 15-30 min, oral 60 min; PROGRESSION: Sedation increases BEFORE respiratory rate drops — a sedated patient who is hard to arouse is a warning sign even if RR is still normal; ANTIDOTE: Naloxone (Narcan) reverses opioid respiratory depression — should be available; ADDITIONAL MONITORING: Constipation (give stool softeners prophylactically); orthostatic hypotension; nausea; urinary retention; LPN role: assess respiratory status before/after, monitor sedation, hold and notify for RR < 12, have naloxone accessible.