A client with terminal cancer reports increasing pain that occurs 1 to 2 hours before the next scheduled dose of a prescribed opioid analgesic. Which action should the practical nurse (PN) implement?

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.

Choice A reason: Range of motion assesses muscle relaxant effectiveness, as these drugs, like cyclobenzaprine, reduce muscle spasms by acting on the central nervous system, relieving pain and improving mobility. Increased leg movement indicates reduced spasm and pain, directly reflecting the drug’s therapeutic action.

Choice B reason: Capillary refill evaluates perfusion, not muscle relaxation. Muscle relaxants target spasms, not vascular status. While pain may indirectly affect circulation, capillary refill does not measure the drug’s primary effect on muscle function, making this choice irrelevant.

Choice C reason: Dependent edema reflects fluid status, not muscle relaxant efficacy. These drugs reduce muscle tension, not swelling. Edema is unrelated to leg pain from spasms, and muscle relaxants do not affect fluid dynamics, making this choice inappropriate for assessment.

Choice D reason: Skin temperature may indicate inflammation or circulation but is not specific to muscle relaxant effects. These drugs alleviate spasms, improving mobility, not temperature. Range of motion directly measures spasm relief, making this choice less relevant for evaluating the medication’s impact.