Which action should the nurse take before administering the prescribed gabapentin regimen?
1Give 300 mg three times daily because age does not affect gabapentin clearance.
2Increase the dose to 600 mg three times daily to overcome reduced absorption.
3Hold the dose and clarify a renal-adjusted regimen with the prescriber.✓ Correct answer
4Crush all scheduled doses together and administer them once each morning.
Explanation
Gabapentin requires dose adjustment in renal impairment. For creatinine clearance greater than 15 to 29 mL/min, the labeled total daily range is 200 to 700 mg given once daily; 300 mg three times daily is therefore inconsistent with the renal dosing table and should be clarified before administration.
Why this is correct Gabapentin clearance falls as renal function declines. The labeled regimen for creatinine clearance greater than 15 to 29 mL/min is a total of 200 to 700 mg once daily, while the order supplies 900 mg each day in three divided doses.
Easy analogy or mental picture When the kidney exit narrows, the dosing traffic must slow down.
Memory hook Gabapentin follows kidney function.
NCLEX decision rule Compare renally cleared medication orders with the current renal dosing table before administration; clarify a mismatch rather than improvising a new schedule.
Why the other choices are wrong The prescribed frequency is excessive for the stated renal function, dose escalation increases accumulation risk, and crushing doses together does not create a validated renal regimen.
References
1DailyMed: GabapentinRenal dose adjustment table for creatinine clearance 15 to 29 mL/min