A client who has moderate, persistent, chronic neuropathic pain due to diabetic neuropathy is taking gabapentin. What is the appropriate nursing action?

• A. Stop the gabapentin immediately
• B. Double the dose without supervision
• C. Continue the gabapentin
• D. Switch to an opioid

Answer: (C)

Continuing gabapentin is the appropriate action. Gabapentin is a common, effective treatment for neuropathic pain from diabetic neuropathy, and its benefits come with the need for stable, properly titrated dosing. Abruptly stopping can cause rebound pain and withdrawal symptoms, and doubling the dose without supervision risks excessive sedation, dizziness, and falls. If the pain remains problematic, dose adjustments should be made in consultation with the prescriber rather than discontinuing or arbitrarily changing therapy. The nurse should also monitor for side effects (dizziness, drowsiness, ataxia), assess renal function for appropriate dosing, and ensure the patient adheres to the prescribed regimen.