Had a pt a few weeks ago that "wasn't acting right" according to nursing staff. Normally the pt was lucid but that day the pt was higher than a kite with constricted pupils due to the massive dose of duragesic she was given. Her breathing was WNL. She would talk minimally when provoked but mostly just smiled. She laid in bed and barely moved which was different because she normally was able to sit up and move around with a walker. PMH included chronic pn, hip fx, multiple spinal fx, etc. I decided not to give her narcan. When I got to the hospital they asked why I didn't give her narcan. I didn't because normally she's depressed and in a lot of pn but that day she was smiling. Why ruin it for her. She was in her late 70s. Anyway, I'm curious what you guys would have done in that situation.