Which action is most important to implement first when a client receiving a meperidine infusion develops seizures?

• A. Stop administration of meperidine
• B. Administer transdermal scopolamine
• C. Administer oxygen (O2) through a facial mask
• D. Monitor respiratory status and sedation level

Answer: (A)

Stopping the meperidine infusion right away is the first and most important step because meperidine and its metabolite normeperidine can precipitate seizures by lowering the brain’s seizure threshold. Removing the offending drug eliminates the immediate trigger and helps halt ongoing seizure activity, reducing the risk of further CNS stimulation. After stopping the infusion, provide supportive care by assessing and maintaining the airway and breathing (oxygen by mask if needed) and closely monitoring respiratory status and sedation level, since opioid infusions can depress respiration. If seizures persist, proceed with the appropriate seizure management and inform the prescriber for further analgesia options.