The patient has been prescribed acyclovir.
The nurse is aware that acyclovir is useful to treat which infection?

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.

Choice A rationale

While temporary numbness could indicate transient nerve compression, which might rarely predispose to minor skin issues if prolonged or repetitive, it typically resolves without lasting dermatological compromise. Sustained pressure or impaired sensation are the primary risk factors for skin breakdown. This transient event is less likely to lead to a significant skin alteration compared to chronic conditions affecting tissue integrity.

Choice B rationale

Diabetes mellitus impairs microcirculation and peripheral neuropathy, leading to decreased sensation and reduced blood flow to tissues. This compromises the skin's ability to heal and resist infection. Hyperglycemia also weakens collagen and elastin, making the skin more fragile and susceptible to breakdown and delayed wound healing.

Choice C rationale

Significant fluid and electrolyte imbalances due to vomiting and diarrhea, coupled with substantial weight loss, lead to dehydration and malnutrition. Dehydration reduces skin turgor and elasticity, making it more prone to tearing. Malnutrition, particularly protein deficiency, impairs tissue repair and maintenance, increasing susceptibility to skin breakdown.

Choice D rationale

Paralysis prevents independent repositioning, leading to prolonged pressure on bony prominences. This sustained pressure compromises capillary blood flow, resulting in tissue ischemia and necrosis. Without the ability to shift weight, the skin's protective mechanisms are overwhelmed, significantly increasing the risk for pressure injury development.

Choice E rationale

Chronic exposure to ultraviolet (UV) radiation from sunlight, experienced by roofers, causes cumulative damage to dermal collagen and elastin fibers, leading to photoaging. This also increases the risk of basal cell carcinoma, squamous cell carcinoma, and melanoma, which are significant skin alterations including premalignant and malignant lesions.