Clients in a nursing home have been prescribed permethrin (Nix) ...

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Clients in a nursing home have been prescribed permethrin (Nix) for head lice. The nurse will question the order for the client who has:
 
  1. seizures.
  2. hypothyroidism.
  3. diabetes mellitus.
  4. an allergy to sulfites.

Question 2

An adolescent is taking isotretinoin (Accutane) for treatment of severe acne. The nurse has completed medication education with the mother and evaluates that additional learning is required when the mother states:
 
  1. I will pay particular attention to her mood now.
  2. I will be sure she has a monthly period.
  3. She might complain of aches and pain.
  4. We will need to check her cholesterol levels.

[dlook33]

Answer to Question 1

Correct Answer: 4
Rationale 1: This medication is not contraindicated in clients with a known seizure disorder.
Rationale 2: There is no contraindication to the use of this medication in a client with hypothyroidism.
Rationale 3: There is no contraindication to the use of this medication in a client with diabetes mellitus.
Rationale 4: This medication is contraindicated in those with an allergy to sulfites.
Global Rationale: This medication is contraindicated in those with an allergy to sulfites. Seizures, hypothyroidism and DM are not contraindications to use of Nix.

Answer to Question 2

Correct Answer: 2
Rationale 1: Severe depression with resulting suicidal ideation can be caused by this drug; the mother must pay attention to her daughter's mood.
Rationale 2: Isotretinoin (Accutane) has a black box warning about the dangers to an unborn fetus. The client must submit to two pregnancy tests and sign a statement of understanding about the drug's adverse effects. Each subsequent month, the pharmacist must document receipt of a negative pregnancy test and verify that two forms of effective contraception are being utilized by the client. Documenting that a monthly menstrual cycle has occurred is not enough.
Rationale 3: Isotretinoin (Accutane) can cause myalgia and arthralgia.
Rationale 4: Isotretinoin (Accutane) can alter blood lipid levels; the daughter must have these values monitored.
Global Rationale: Isotretinoin (Accutane) has a black box warning about the dangers to an unborn fetus. The client must submit to two pregnancy tests and sign a statement of understanding about the drug's adverse effects. Each subsequent month, the pharmacist must document receipt of a negative pregnancy test and verify that two forms of effective contraception are being utilized by the client. Documenting that a monthly menstrual cycle has occurred is not enough. Severe depression with resulting suicidal ideation can be caused by this drug; the mother must pay attention to her daughter's mood. Isotretinoin (Accutane) can cause myalgia and arthralgia. Isotretinoin (Accutane) can alter blood lipid levels; the daughter must have these values monitored.

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Thank you!

[dlook33]

Always glad to help...