A client with irritable bowel syndrome with diarrhea reports a prior cholecystectomy and receives an eluxadoline prescription. Which action is best?

1 Hold eluxadoline and obtain prompt review because it is contraindicated without a gallbladder. ✓ Correct answer
2 Give the first dose with alcohol to reduce the risk of abdominal discomfort.
3 Start a double dose because cholecystectomy lowers the risk of pancreatitis.
4 Continue the prescription and report pain only after several weeks of therapy.

Explanation

Eluxadoline is contraindicated in clients without a gallbladder because serious and fatal pancreatitis and sphincter of Oddi spasm have occurred, sometimes after 1 or 2 doses.

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In-depth explanation

Quick answer
Block eluxadoline exposure after cholecystectomy.

Why this is correct
The safety screen occurs before the first dose. Waiting for symptoms exposes the client to a known contraindication.

Easy analogy or mental picture
Use a closed medication-safety loop: identify the exposure, connect the new findings, interrupt further harm, support physiology, and verify the response over time.

Memory hook
Exposure, interaction, toxicity pattern, immediate action, serial reassessment.

NCLEX decision rule
Choose the action that reduces the most immediate medication-related risk while preserving monitoring and escalation.

Why the other choices are wrong
Options that continue the exposure, treat only one symptom, or delay reassessment leave the toxic process active.

References

1DailyMed: VIBERZI (eluxadoline)Contraindication without a gallbladder and risk of pancreatitis or sphincter of Oddi spasm

Clinical scenario

Medication safety review
Verify the indication, route, interacting medicines, current respiratory and gastrointestinal findings, authorized action, and measurable follow-up.

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For study reference only. Always follow current clinical guidelines and your institution’s protocols.

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A client with irritable bowel syndrome with diarrhea reports a prior cholecystectomy and receives an eluxadoline prescription. Which action is best?

In-depth explanation

Clinical scenario

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