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A nurse is caring for an adolescent in the outpatient dermatologist's office.

 

Exhibits

Complete the following sentence by using the lists of options.

A nurse is providing education today on the newly-prescribed medication. The nurse recommends the adolescent notify the provider immediately if

or occurs during therapy.
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"A"}

Rationale for Correct Choices:

  • A change in mood: Isotretinoin can cause psychiatric effects such as depression, mood swings, and suicidal ideation. These symptoms may appear suddenly and progress rapidly without warning. Immediate reporting is necessary to ensure patient safety and initiate intervention.
  • Visual disturbances: Isotretinoin may cause night blindness, blurred vision, or other changes in visual acuity. These effects can be irreversible if not addressed promptly by an ophthalmologic evaluation. Sudden onset visual changes require immediate discontinuation and assessment.

Rationale for Incorrect Choices:

  • Nausea: This is a mild, nonspecific gastrointestinal symptom that may occur with many oral medications. It is not considered a hallmark of isotretinoin toxicity unless severe or persistent. Supportive measures are usually sufficient unless other symptoms emerge.
  • The development of dry eyes: This occurs due to isotretinoin’s suppression of sebaceous and meibomian gland activity. It is a common, expected effect that can be relieved with lubricating eye drops. Urgent evaluation is not required unless accompanied by vision changes.
  • Dry mouth: This is a frequent mucocutaneous effect related to reduced salivary gland activity during isotretinoin therapy. It does not indicate a dangerous reaction and is usually managed with hydration and sugar-free lozenges. Medical review is only needed if severe.
  • Photosensitivity: Isotretinoin increases skin sensitivity to sunlight due to thinning of the epidermis. While uncomfortable, it is a predictable effect that can be prevented with sunscreen and protective clothing. It does not require stopping treatment unless severe burns occur.
  • Dry skin and lips: This is the most common side effect, resulting from reduced sebaceous gland activity. It is usually managed with moisturizers and lip balm throughout therapy. It is not a sign of toxicity and rarely requires dose adjustment.


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Related Questions

Correct Answer is ["A","B","D","E"]

Explanation

Rationale for correct choices:

  • Skin turgor: Poor skin turgor indicates dehydration, which can lead to electrolyte imbalances, hypotension, and renal complications. Immediate assessment and fluid management are necessary to prevent further physiological deterioration.
  • Heart rate: A heart rate of 120/min is tachycardic. This can be caused by dehydration, stimulant effects of mania, or other underlying medical issues. It requires prompt monitoring and intervention to prevent cardiovascular compromise.
  • Sleep pattern: The client has not slept for 2 days, which increases the risk for physical exhaustion, worsening psychiatric symptoms, and impaired judgment. Sleep deprivation in the context of mania requires immediate attention to stabilize the client.
  • Hallucinations: The client reports listening to unseen others, indicating auditory hallucinations. This can pose a risk for self-harm or unsafe behaviors, and immediate psychiatric assessment and intervention are warranted.

Rationale for incorrect choice:

  • Hygiene: While the client’s hair and clothing are unclean, indicating self-care deficits, this is not an immediate threat to physiological stability. It is important for overall care planning but does not require urgent intervention compared to dehydration, tachycardia, sleep deprivation, or hallucinations.

Correct Answer is A

Explanation

Rationale:

A. Food exchange lists for meal planning from the American Diabetes Association: The ADA provides evidence-based, reliable resources for meal planning that help clients manage blood glucose levels and make informed dietary choices. These lists are tailored for diabetes management.

B. Food label recommendations from the Institute of Medicine: While the IOM provides general nutrition guidelines, they are not specifically designed for diabetes management and may not address individualized meal planning needs for blood glucose control.

C. Diabetes medication information from the Physicians' Desk Reference: The PDR contains medication details but is intended for healthcare professionals, not clients. It may be too technical for patient education purposes.

D. Personal blogs about managing the adverse effects of diabetes medications: Blogs may provide anecdotal information that is not evidence-based and could be inaccurate or misleading, making them an unreliable resource for client education.

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