Need thought processes

I need some help with my thought process. Today I had a resident with deteriorating mental status, beginning of shift was awake and mildly confused. Normal base line is awake and alert orientated x3. Started on fentanyl patch 2 days prior. Midway thro shift noticed increase in confusion and started neuro checks, later in the shift resident is with increase in lethargy and becoming stuporus, increase confusion orientated to person only. Notified MD to remove fentanyl patch, fentanyl patch removed and area cleaned. patient back to baseline by end of shift, But requesting opiates for pain management. I was relucantent to give the opiates due to the events prior, but the resident insisted and become aggressive when I voiced concern. I gave her percocet x2 tabs as she wanted, still not wanting to give them to her, I did a complete neuro check and vitals, everything was back to baseline. I was just wondering if anyone has anything else they would have done, or maybe something I missed all feedback is great. Thanks