Nokea
A female patient will be starting therapy with oral isotretinoin as part of treatment for severe acne, and the nurse is providing teaching. Which teaching point will the nurse include in her teaching plan about isotretinoin?
- A. You will have to use two contraceptive methods while on this drug.
- B. You must avoid sexual activity while on this drug.
- C. You will have to avoid pregnancy for 2 weeks after taking this drug.
- D. If you are taking an oral contraceptive, you may take this drug.
Correct Answer: A
Rationale: It is now required that at least two contraceptive methods be used by sexually active women during and for 1 month after completion of therapy with isotretinoin.
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A patient asks about using minoxidil for hair thinning. Which statement about minoxidil is accurate?
- A. The product is applied once daily in the morning.
- B. Systemic absorption of topically applied minoxidil is rare.
- C. Results may be seen as soon as 2 weeks after beginning therapy.
- D. Systemic absorption may cause tachycardia, fluid retention, and weight gain.
Correct Answer: D
Rationale: Results of minoxidil therapy may not be seen for 4 months after beginning therapy. The product is applied twice daily, morning and evening, and systemic effects may result because of absorption.
A patient is considering taking oral aloe supplements and asks the nurse about potential problems with this therapy. Which statement by the nurse is correct?
- A. Aloe is not taken orally; it is only used topically to aid in wound healing.
- B. Aloe is used by some to treat constipation; it may cause diarrhea.
- C. This is a safe herbal supplement, with no known drug interactions.
- D. This is a safe herbal supplement, with no known adverse effects.
Correct Answer: B
Rationale: The dried juice of the leaves of the aloe plant contains anthranoids, which give aloe a laxative effect when taken orally. The topical application of the plant juice has been known for years to help the healing of wounds. Common adverse effects include diarrhea, nephritis, abdominal pain, and dermatitis when used topically.
Which adverse effects will the nurse expect in a teenage patient who is using topical tretinoin? (Select all that apply.)
- A. Crusted skin
- B. Itching
- C. Altered skin pigmentation
- D. Rosacea
- E. Red and edematous blisters
Correct Answer: A,C,E
Rationale: Some of the most common adverse effects of tretinoin are excessively red and edematous blisters, crusted skin, and temporary alterations in skin pigmentation.
A patient is admitted to the hospital for possible septicemia. He has a large pressure ulcer on his heel that is open and includes necrotic tissue. However, his prothrombin time/international normalized ratio (PT/INR) values are too high to permit surgical debridement at this time. The nurse expects that which wound-care product will be used to treat the wound?
- A. Cadexomer iodine
- B. Biafine topical emulsion
- C. Povidone-iodine
- D. Collagenase
Correct Answer: D
Rationale: Because this patient has an elevated PT/INR, he cannot receive surgical debridement because of concerns about excessive bleeding. Collagenase is useful for patients taking anticoagulants and for those in whom surgery is contraindicated; it selectively removes necrotic tissue but does not harm normal tissue.
A teenage boy is taking tretinoin for acne. Which statement will the nurse include in the teaching plan?
- A. Avoid foods that are heavy in salt and oils.
- B. This drug may cause increased redness of your skin.
- C. Try using an abrasive cleanser to remove old skin layers.
- D. Being out in the sunlight will help your skin heal.
Correct Answer: B
Rationale: Tretinoin may cause increased redness and drying, and the patient needs to avoid weather extremes, ultraviolet light, and abrasive cleansers. Certain foods do not need to be avoided.