The nurse is reviewing prescriptions for the assigned clients. Which prescription should the nurse question?

Question

The nurse is reviewing prescriptions for the assigned clients.  Which prescription should the nurse question?

Quizplus · Accepted Answer

Dicyclomine (Bentyl) is an anticholinergic/antispasmodic drug prescribed to manage symptoms of intestinal hypermotility in clients with irritable bowel syndrome. Dicyclomine is contraindicated in clients with paralytic ileus as it decreases intestinal motility and would exacerbate the condition (Option B). The nurse should question this prescription and contact the health care provider. (Option A) Tumor lysis syndrome occurs due to rapid lysis of cells and the resulting release of intracellular potassium and phosphorus into serum. Phosphorus binds to calcium, leading to hypocalcemia. The breakdown of cellular nucleic acids causes severe hyperuricemia. IV hydration and hypouricemic medications (eg, allopurinol) are prescribed to promote purine excretion and prevent acute kidney injury. (Option C) Although opioids (eg, morphine) can cause constipation, symptoms can be managed with pharmacologic (eg, docusate sodium, sennoside) and nonpharmacologic interventions (eg, increased activity, increased fiber and fluid intake). Percutaneous nephrolithotripsy breaks and removes kidney stones, and can lead to severe pain. Therefore, pain medication is appropriate. (Option D) Levofloxacin, a fluoroquinolone antibiotic prescribed to treat urinary tract infections, has no known cross-sensitivity to penicillin. However, cross-sensitivity with other fluoroquinolones can occur. Educational objective: Dicyclomine is an antispasmodic drug that decreases intestinal motility and is contraindicated in clients with paralytic ileus.

The Nurse Is Reviewing Prescriptions for the Assigned Clients