A 72-year-old client with chronic kidney disease (eGFR 28 mL/min) is prescribed gabapentin 300 mg PO three tim…

Question

A 72-year-old client with chronic kidney disease (eGFR 28 mL/min) is prescribed gabapentin 300 mg PO three times daily for postherpetic neuralgia. Which is the nurse's priority action?

Accepted Answer

Option 1: Hold the dose and contact the provider to discuss renal dose adjustment — gabapentin is renally cleared and accumulates in CKD

Correct (2): Gabapentin is renally eliminated; in eGFR 15-29, dose should be reduced (e.g., 200-700 mg/day in divided doses). Failure to adjust causes accumulation with sedation, ataxia, falls, and respiratory depression — especially dangerous in older adults. (1) Standard dose risks toxicity. (3) Higher dose worsens harm. (4) Administration route does not change the underlying issue.

Answer

Option 2: Administer the prescribed dose of gabapentin 300 mg PO TID to manage postherpetic neuralgia pain effectively

Answer

Option 3: Titrate the gabapentin dose to 600 mg three times daily since the current dose is subtherapeutic for postherpetic neuralgia

Answer

Option 4: Crush the gabapentin capsule and mix with applesauce for administration because older adults commonly have difficulty swallowing pills

A 72-year-old client with chronic kidney disease (eGFR 28 mL/min) is prescribed gabapentin 300 mg PO three times daily for postherpetic neuralgia. Which is the nurse's priority action?

In-depth explanation

Clinical scenario

Key concepts

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A 72-year-old client with chronic kidney disease (eGFR 28 mL/min) is prescribed gabapentin 300 mg PO three times daily for postherpetic neuralgia. Which is the nurse's priority action?

In-depth explanation

Clinical scenario

Key concepts

Master the NCLEX-RN with MyMerci