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

Choice A rationale

Urinary tract infections can cause bladder irritation and dysfunction, leading to symptoms such as frequency, urgency, and nocturia, which can manifest as enuresis, especially secondary enuresis (bedwetting that starts after a period of dryness). Therefore, assessing for a UTI is a crucial first step to rule out a treatable medical cause. Normal urine specific gravity ranges from 1.005 to 1.030, and a urinalysis can detect the presence of bacteria, white blood cells, or nitrites indicative of infection.

Choice B rationale

Psychological stressors can contribute to enuresis, particularly secondary enuresis. Anxiety, family changes, or school-related stress can manifest physically. While important to explore, medical causes like UTIs should be ruled out first.

Choice C rationale

Sleep patterns are relevant in the context of enuresis, as bedwetting occurs during sleep. However, assessing for a medical cause like a UTI should precede a detailed evaluation of sleep habits.

Choice D rationale

A family history of enuresis can suggest a genetic predisposition. However, the immediate nursing priority is to assess for and rule out treatable underlying medical conditions, such as a urinary tract infection.

Choice A rationale

Preschoolers (ages 3-5 years) are at risk for drowning, often due to their increasing independence and exploration without fully understanding water hazards. However, they are generally more coordinated than toddlers and may have some understanding of safety rules.

Choice B rationale

Toddlers (ages 1-3 years) are at the greatest risk for drowning due to their natural curiosity, developing mobility, and lack of awareness of danger. They can wander off and fall into pools, bathtubs, or even buckets of water. Their head-to-body ratio makes it difficult for them to lift their heads if they fall face-first into water.

Choice C rationale

Infants (under 1 year) are dependent on caregivers and are typically supervised closely around water. While they can drown in shallow water, their lack of mobility reduces their risk compared to toddlers who are actively exploring their environment.

Choice D rationale

Teenagers, while still at risk for drowning, often due to risk-taking behaviors around water or substance use, generally have a better understanding of water safety than younger children and are more physically capable in the water.