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:

Question

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."

Answer 1

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.