A client on a continuous IV infusion of meperidine exhibits confusion and hallucinations. What should the nurse do first?

In the case of a client exhibiting confusion and hallucinations while on a continuous IV infusion of meperidine, decreasing the IV infusion rate of the meperidine is appropriate because these symptoms can indicate that the client may be experiencing toxicity or an adverse effect from the medication. Meperidine, an opioid analgesic, can cause central nervous system side effects, especially in cases of accumulation or overdose, potentially leading to confusion and hallucinations.

By reducing the infusion rate, the nurse can help to mitigate the risk of further accumulation of the drug in the client's system, allowing for a safer management of the client's symptoms. This intervention may stabilize the patient and prevent further adverse effects while additional assessments and interventions are planned.

Other options, such as administering naloxone, would be considered if there was significant respiratory depression or a risk of overdose, which may not directly correlate with the client's current symptoms. Administering a PRN dose of oral meperidine would exacerbate the situation rather than address it, and notifying the healthcare provider is typically necessary, but addressing the immediate symptoms by adjusting the medication infusion takes precedence.