A patient is diagnosed with contact dermatitis.
Which medication should the nurse expect to be prescribed to treat this disorder?

Choice A rationale

Fever is a systemic manifestation of infection, indicating a generalized inflammatory response, and is typically not classified as a lower urinary tract symptom. Lower urinary tract symptoms are directly related to bladder and urethral irritation. While a UTI can cause fever, it's a systemic sign, not a localizing symptom. Normal body temperature ranges from 36.5°C to 37.5°C orally.

Choice B rationale

Hesitancy refers to difficulty initiating urination, a symptom directly linked to lower urinary tract dysfunction. Inflammation and irritation of the bladder neck or urethra, often due to bacterial presence in a UTI, can impede smooth detrusor muscle contraction and sphincter relaxation, leading to this symptom. It reflects impaired micturition coordination.

Choice C rationale

Nocturia, the need to wake up and urinate multiple times during the night, is a common lower urinary tract symptom in UTIs. Inflammation of the bladder lining increases bladder sensitivity and reduces its functional capacity, leading to more frequent urges to void, even during sleep, disrupting normal sleep patterns.

Choice D rationale

Dysuria, or painful urination, is a hallmark lower urinary tract symptom of a UTI. The inflammation and irritation of the urethral mucosa and bladder trigone by bacterial toxins and the host immune response cause direct stimulation of nociceptors during the passage of urine, resulting in a burning sensation.

Choice E rationale

Incomplete emptying describes the sensation that the bladder has not been fully emptied after urination. This symptom arises from bladder irritation and detrusor muscle dysfunction or spasm due to inflammation in a UTI, leading to residual urine and persistent urge, even after voiding efforts.

Choice F rationale

Hematuria, the presence of blood in the urine, is a lower urinary tract symptom that can occur with UTIs. Inflammation and irritation of the urothelium by bacterial colonization can lead to micro-erosions and increased vascular permeability in the bladder and urethra, causing red blood cells to leak into the urine.

Choice G rationale

Chills are systemic symptoms, often accompanying fever, indicating a generalized inflammatory response and potential systemic spread of infection. Like fever, chills are not considered a direct lower urinary tract symptom, which specifically relates to local irritation and dysfunction of the bladder and urethra.

Choice A rationale

Discoloration of the teeth is not a common side effect associated with retinoid medications. Tetracycline antibiotics are well-known for causing tooth discoloration, particularly in developing teeth. Retinoids primarily affect cell differentiation, proliferation, and immune function, but not dental chromogenesis.

Choice B rationale

Monthly lab work is not routinely required to ensure the proper dose of most retinoid medications, though baseline liver function tests and lipid profiles may be checked, especially with systemic retinoids, due to potential hepatotoxicity and dyslipidemia. However, the dose is primarily guided by clinical response and side effects, not frequent lab adjustments.

Choice C rationale

While some retinoids, such as tretinoin, are used topically for certain precancerous skin lesions like actinic keratosis due to their ability to normalize cell differentiation, they are generally not considered primary treatments for established cancerous lesions. Their role is more in prevention or adjunctive therapy rather than definitive cancer treatment.

Choice D rationale

Retinoids, particularly systemic retinoids like isotretinoin, are highly teratogenic, meaning they can cause severe birth defects. Therefore, strict avoidance of pregnancy is crucial, often requiring two forms of contraception. Additionally, retinoids increase photosensitivity, making sun avoidance and protective measures essential to prevent severe sunburn and skin damage.