What nursing action is a priority for a child receiving isotretinoin?
Administer with high-fat meals.
Monitor for photosensitivity.
Ensure two forms of contraception are in use.
Encourage increased dairy intake.
The Correct Answer is C
Choice A rationale
Isotretinoin absorption is enhanced with high-fat meals because it is a lipophilic drug. While this is important for maximizing the medication's effectiveness, it is not the priority nursing action related to the significant risks associated with the drug.
Choice B rationale
Isotretinoin can cause increased photosensitivity, making the skin more susceptible to sunburn. Monitoring for and educating the child and family about sun protection measures, such as sunscreen and protective clothing, is crucial to prevent skin damage.
Choice C rationale
Isotretinoin is a known teratogen, meaning it can cause severe birth defects if taken during pregnancy. Therefore, ensuring that female patients of childbearing potential are using two effective forms of contraception and have a negative pregnancy test before starting treatment is a paramount safety concern and a priority nursing action.
Choice D rationale
There is no specific contraindication or recommendation regarding increased dairy intake for children receiving isotretinoin. Dairy intake does not directly address the major risks associated with the medication.
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Related Questions
Correct Answer is B
Explanation
Choice B rationale
Regular soda contains high amounts of simple sugars, which will rapidly increase blood glucose levels. For a child with type 1 diabetes experiencing hypoglycemia (low blood sugar), a quick-acting source of glucose like juice or glucose tablets is preferred over regular soda due to its predictable and faster absorption.
Correct Answer is A
Explanation
Choice A rationale
Nephroblastoma, also known as Wilms tumor, is the most common malignant renal tumor in young children, typically presenting between the ages of 3 and 4 years. A firm, non-tender abdominal mass, often in the right flank, is a classic finding. The association with aniridia, a congenital absence of the iris, is a known risk factor for Wilms tumor, occurring in WAGR syndrome (Wilms tumor, aniridia, genitourinary anomalies, and intellectual disability).
Choice B rationale
Neuroblastoma is a cancer that arises from immature nerve cells and can occur in various locations, most commonly the adrenal glands. While it can present with an abdominal mass, it is often associated with other symptoms such as fever, weight loss, and irritability due to catecholamine secretion. It is less specifically linked to aniridia than nephroblastoma.
Choice C rationale
Hepatoblastoma is a rare malignant tumor of the liver that typically presents in children younger than 3 years old. While it causes abdominal swelling due to a liver mass, it is not typically associated with aniridia. Palpation might reveal a mass in the upper right quadrant rather than the flank.
Choice D rationale
Hydronephrosis refers to the swelling of a kidney due to a buildup of urine. While it can cause an abdominal mass, it is often associated with urinary symptoms or pain, which are not reported in this case. Furthermore, it is not a malignancy and has no known association with aniridia.
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