A client with overactive bladder starts a new prescription for oxybutynin. When assessing the client prior to medication administration, which finding should the practical nurse (PN) report to the charge nurse?

Choice A reason: Avoiding grapefruit juice is correct, as it inhibits CYP3A4, an enzyme metabolizing itraconazole, potentially increasing drug levels and toxicity. This shows understanding, as grapefruit juice can alter the drug’s pharmacokinetics, leading to adverse effects. No additional instruction is needed for this statement.

Choice B reason: Taking itraconazole with antacids reduces its absorption, as it requires an acidic stomach environment for optimal bioavailability. Antacids neutralize gastric acid, decreasing drug efficacy. This statement indicates a misunderstanding, necessitating further instruction to ensure effective antifungal treatment.

Choice C reason: Monitoring stool color changes is reasonable, as itraconazole can cause hepatotoxicity, potentially altering stool appearance due to liver dysfunction. This shows awareness of side effects, requiring no additional instruction, as it aligns with monitoring for adverse hepatic effects.

Choice D reason: Reporting breathing difficulty is appropriate, as itraconazole may rarely cause pulmonary side effects or exacerbate heart failure. This indicates understanding of serious adverse effects, requiring no further instruction, as it reflects vigilance for critical symptoms needing medical attention.

Choice A reason: Observing ulcer healing is important in diabetic neuropathy but not a direct measure of pregabalin’s effectiveness. Pregabalin reduces neuropathic pain, not primarily promoting tissue repair. Ulcer healing depends on glycemic control and wound care, making this choice secondary.

Choice B reason: Measuring pain and sensation assesses pregabalin’s effectiveness, as it modulates calcium channels in neurons, reducing neuropathic pain and abnormal sensations in diabetic neuropathy. Decreased pain or paresthesia in the feet indicates therapeutic success, making this the most relevant assessment for the drug’s action.

Choice C reason: Palpating skin temperature evaluates circulation or infection, not pregabalin’s effect. While neuropathy may affect perfusion, pregabalin targets pain signaling, not temperature regulation. This assessment is unrelated to the drug’s primary role in pain management, making it irrelevant.

Choice D reason: Checking swelling monitors edema, which may occur in diabetes but is not pregabalin’s target. The drug reduces neuropathic pain, not fluid accumulation. Swelling assessment is secondary to pain and sensation, which directly reflect the medication’s efficacy in neuropathy management.