What nursing action is a priority for a child receiving isotretinoin?

Choice A rationale

Myoclonic seizures are characterized by brief, sudden, involuntary muscle jerks or twitches. These movements are typically not associated with a complete loss of postural tone leading to a fall. The child's presentation of suddenly dropping to the floor without warning indicates a loss of muscle strength.

Choice B rationale

Atonic seizures, also known as drop attacks, involve a sudden loss of muscle tone, causing the individual to fall abruptly. This loss of tone can be localized or generalized, affecting the entire body, which aligns with the description of the child suddenly dropping to the floor.

Choice C rationale

Absence seizures are characterized by brief lapses of consciousness, often appearing as a staring spell. Individuals usually do not fall during an absence seizure; instead, they may have subtle motor movements like eye blinking or lip smacking.

Choice D rationale

Tonic seizures involve a sudden increase in muscle tone, causing stiffening of the body, arms, or legs. While a person might fall due to the rigidity, the primary characteristic is muscle stiffening, not a sudden loss of tone.

Choice A rationale

Irritability after feedings can be a common symptom of GER due to stomach acid refluxing into the esophagus and causing discomfort. While it should be reported, it is not necessarily an immediate sign of a serious complication.

Choice B rationale

A slight decrease in appetite can occur with GER due to discomfort or a learned aversion to feeding. While it warrants monitoring, it is not typically an immediate red flag for severe complications.

Choice C rationale

Coughing or wheezing during sleep can indicate aspiration of gastric contents into the airway due to severe GER. Aspiration can lead to respiratory complications such as pneumonia, making this a serious sign that requires immediate medical attention.

Choice D rationale

Occasional spitting up after feedings is a common manifestation of GER in infants and is often physiological. While frequent or forceful spitting up should be monitored, occasional spitting up in a 9-month-old with known GER is not necessarily a sign of a serious complication requiring immediate reporting.