The practical nurse (PN) administers a skeletal muscle relaxant to a client with left leg pain. Which assessment provides data related to the effectiveness of the medication?

Choice A reason: Ankle circumference monitors edema, which mannitol reduces by drawing fluid from tissues. However, this is secondary to urinary output, as mannitol’s primary action is diuresis, increasing urine production to reduce intracranial or intraocular pressure, making edema measurement less critical.

Choice B reason: Heart rate is relevant for overall monitoring but not the primary outcome for mannitol, which acts as an osmotic diuretic. Cardiovascular effects are secondary, and mannitol’s efficacy is better assessed by urine output, which directly reflects its diuretic mechanism.

Choice C reason: Dietary intake is unrelated to mannitol’s therapeutic effect. Mannitol pulls fluid into the bloodstream, increasing urine output, not influenced by diet. Monitoring intake may be relevant for other conditions, but it is not critical for assessing mannitol’s diuretic action.

Choice D reason: Urinary output is the most important outcome, as mannitol, an osmotic diuretic, increases urine production by drawing fluid into the renal tubules, reducing intracranial or intraocular pressure. Adequate output (e.g., >30 mL/hour) confirms efficacy, preventing fluid overload or renal complications.

Choice A reason: Keratolytic agents, like salicylic acid, break down keratin in psoriatic plaques, softening scaly skin and reducing peeling. This promotes shedding of thickened, dead skin cells, improving skin texture. Softer, less scaly skin directly indicates the medication’s effect on hyperkeratotic lesions, confirming therapeutic success.

Choice B reason: Absence of purulent drainage indicates no infection but is not the primary goal of keratolytics. These agents target scale reduction, not infection. Psoriasis lesions are typically not purulent, so this finding is unrelated to the medication’s intended effect on skin texture.

Choice C reason: Reduced redness and swelling suggest decreased inflammation, which is not the primary action of keratolytics. Anti-inflammatory agents, like corticosteroids, target these symptoms, while keratolytics focus on scale removal. This finding is irrelevant to the medication’s specific role in psoriasis management.

Choice D reason: Full range of motion without pain relates to joint function, possibly in psoriatic arthritis, but is unrelated to keratolytics, which treat skin lesions. Keratolytics do not affect joint inflammation or mobility, making this choice incorrect for assessing the medication’s skin-specific effects.