To assess for pruritus in a patient on opioids, the nurse should...

• A. Observe itching and skin reactions.
• B. Measure blood oxygen saturation.
• C. Check urinary output.
• D. Assess for facial droop.

Answer: (A)

Opioid-induced pruritus is a common adverse effect that can occur due to histamine release and central nervous system effects of the drug. To assess it, focus on the patient’s experience and visible signs: ask the patient to describe any itching, note the intensity and location, and observe for scratching or skin changes such as excoriations, flushing, or rashes. Pruritus can occur with or without a visible rash, so the patient’s subjective report is essential and should be paired with careful observation of the skin and scratching patterns.

This assessment direction matches why pruritus is being evaluated in someone receiving opioids, rather than monitoring oxygen saturation, urinary output, or facial motor function, which relate to respiratory status, renal/urinary status, and neurologic deficits, respectively. If pruritus is identified, consider adjusting analgesia or adding antihistamines, but the priority here is confirming the presence and extent of itching and skin reactions.