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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":"C","dropdown-group-2":"D"}

  • Dry skin and lips: This is a very common side effect of isotretinoin due to its drying effects on sebaceous glands. It is expected and manageable with regular moisturizing and is not considered an emergency.
  • Increased appetite: Isotretinoin is not associated with increased appetite. Weight changes are not typical or concerning symptoms during therapy and do not warrant urgent provider notification.
  • Depression: Isotretinoin has been associated with mood changes including depression, suicidal thoughts, and other psychiatric effects. These can emerge suddenly and must be reported immediately for prompt evaluation and intervention to ensure safety.
  • Visual disturbances: Blurred vision or difficulty seeing, particularly at night, can indicate rare but serious complications such as increased intracranial pressure. Any change in vision during isotretinoin therapy requires immediate medical attention.
  • Productive cough: This is not commonly linked with isotretinoin therapy. Unless respiratory symptoms worsen or are accompanied by fever or systemic signs, a productive cough alone is not a reason to stop treatment or alert the provider urgently.


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Related Questions

Correct Answer is D

Explanation

A. "Why are you eating seaweed soup?" This response is judgmental and dismissive of the client’s cultural practices. It can make the client feel misunderstood or disrespected.
B. "The hospital food is more nutritious for you." This statement is inaccurate and culturally insensitive, assuming that hospital food is superior without recognizing the nutritional and emotional value of traditional foods.
C. "Does the doctor know that you are eating that?" This implies unnecessary medical concern and may make the client feel like her personal choices require approval, which can be disempowering and disrespectful.
D. "Of course, I will heat that up for you." This response is supportive and culturally competent, respecting the client's traditions and preferences while promoting comfort and emotional well-being during the postpartum period.

Correct Answer is A

Explanation

A. Respiratory rate 10/min. This is the priority finding because it suggests respiratory depression, a serious side effect of magnesium sulfate therapy. Magnesium acts as a CNS depressant, and a respiratory rate below 12/min is a potential sign of magnesium toxicity, which can lead to respiratory arrest if not promptly addressed.
B. 2+ deep-tendon reflexes. This indicates normal neuromuscular function and is actually a reassuring finding in a client receiving magnesium sulfate. Reflexes are typically monitored to detect early signs of toxicity, and a 2+ rating means the dose is likely therapeutic.
C. 3+ pedal edema. While significant, pedal edema is a common feature of preeclampsia and not directly related to magnesium sulfate toxicity. It should be monitored but does not require immediate action compared to respiratory compromise.
D. Urinary output 35 mL/hr. This is slightly above the minimum acceptable output of 30 mL/hr, indicating the kidneys are excreting adequately. While magnesium is excreted renally and output must be monitored, this value does not indicate an acute risk.

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