A 30-year old woman who has been taking isotretinoin (Accutane) to treat severe cystic acne makes all these statements while being seen for a follow-up examination. Which statement is of most concern?
A. "Sometimes I get nauseated after taking the medication."
B. "My husband and I are thinking of starting a family soon."
C. "I have been having problems driving when it gets dark."
D. "I don't think there has been much improvement in my skin."
Correct Answer: B. “My husband and I are thinking of starting a family soon.”
Isotretinoin (Accutane) is associated with a high incidence of birth defects, it is important that the client stops using the medication at least a month before attempting to become pregnant.
Options A and C: Poor night vision and nausea are possible adverse effects of isotretinoin that would require further assessment but are not as urgent as discussing the fetal risks associated with this medication.
Option D: The client’s concern about the effectiveness of the medication should be addressed, but this is a low-priority intervention.
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