The physician has ordered bethanechol (Urecholine), a cholinergic drug, for the patient with urinary retention. The patient also has an enlarged prostate gland. What is the priority action by the nurse?
1. Hold the drug and prepare to catheterize the patient.
2. Administer the drug and measure urinary output.
3. Administer the drug and push fluids.
4. Hold the drug and contact the physician.
Correct Answer: 4
Rationale: Bethanechol (Urecholine) relaxes the urinary sphincter and increases voiding pressure. It is contraindicated with any physical obstruction of the urinary tract, such as an enlarged prostate gland. Measuring urinary output is inappropriate; the patient should not receive the drug. There should be no need for catheterization as long as the drug is not given. The drug should not be given; pushing fluids would exacerbate the problem.
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