CANS Risk Management & Mitigation 2 — Questions and Answers
Question 1: A patient develops sudden visual changes and severe headache 20 minutes after periorbital filler injection. What is the FIRST intervention?
- Administer oral antihistamine
- Inject hyaluronidase immediately and call 911 (Correct answer)
- Apply warm compress to the area
- Document and monitor for 30 minutes
Correct answer: Inject hyaluronidase immediately and call 911
Vascular occlusion causing vision changes is an ophthalmic emergency requiring immediate hyaluronidase injection and emergency services activation.
Question 2: Which documentation element is MOST critical for defending against a malpractice claim following an aesthetic complication?
- Before-and-after photographs only
- Detailed informed consent with patient signature and witnessed date (Correct answer)
- Product lot numbers used during treatment
- Staff names present during the procedure
Correct answer: Detailed informed consent with patient signature and witnessed date
Signed, dated informed consent documenting discussed risks is the cornerstone legal defense in malpractice litigation.
Question 3: A patient with a history of cold sores requests lip augmentation with HA filler. The safest risk management approach is to:
- Decline treatment permanently due to liability
- Proceed without any modification
- Prescribe antiviral prophylaxis starting 2–3 days before treatment (Correct answer)
- Use a different filler product to avoid viral activation
Correct answer: Prescribe antiviral prophylaxis starting 2–3 days before treatment
Antiviral prophylaxis (e.g., valacyclovir) initiated 2–3 days pre-treatment significantly reduces HSV reactivation risk in susceptible patients.
Question 4: When performing a risk-benefit discussion with an aesthetic patient, the BEST practice is to:
- Focus only on expected outcomes to reduce patient anxiety
- Use standardized forms without personalized discussion
- Tailor the discussion to each patient's medical history and treatment plan (Correct answer)
- Have the patient read the consent form independently without questions
Correct answer: Tailor the discussion to each patient's medical history and treatment plan
Individualized informed consent discussions that address patient-specific risks and goals reflect the standard of care in aesthetic nursing.
Question 5: A patient develops a firm nodule 6 weeks after HA filler injection. Which initial management step is most appropriate?
- Reassure the patient it will resolve spontaneously within days
- Immediately perform surgical excision
- Assess for infection vs. granuloma and consider hyaluronidase or antibiotics accordingly (Correct answer)
- Inject additional filler to camouflage the nodule
Correct answer: Assess for infection vs. granuloma and consider hyaluronidase or antibiotics accordingly
Delayed nodules require differentiation between infectious and inflammatory/granulomatous causes before selecting hyaluronidase, antibiotics, or steroid injection.
Question 6: Which patient factor represents the HIGHEST risk for poor wound healing after laser resurfacing?
- Age over 40
- Current use of isotretinoin within the past 6–12 months (Correct answer)
- Fitzpatrick skin type II
- Prior chemical peel 2 years ago
Correct answer: Current use of isotretinoin within the past 6–12 months
Recent isotretinoin use (within 6–12 months) impairs sebaceous gland function and collagen remodeling, significantly increasing scarring risk after ablative procedures.
Question 7: Under the CANS scope of practice, which action requires direct physician supervision or a standing order?
- Performing a medical history intake
- Obtaining before-and-after photographs
- Injecting neurotoxins or dermal fillers (Correct answer)
- Scheduling follow-up appointments
Correct answer: Injecting neurotoxins or dermal fillers
Injectable aesthetic treatments fall within medical procedures that legally require a physician's oversight, delegation, or collaborative agreement depending on state law.
CANS Risk Management & Mitigation 2
A patient develops sudden visual changes and severe headache 20 minutes after periorbital filler injection.
What is the FIRST intervention?