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Difficulty: MediumPharmacological Therapies

It is time for a client's scheduled transdermal fentanyl patch replacement. To ensure safe medication administration, arrange the following steps in the correct chronological sequence.

  1. 1Perform hand hygiene and verify the client's identity using two standard identifiers.
  2. 2Don clean gloves, then locate and remove the previously applied patch.
  3. 3Cleanse a new, hairless area of skin on the upper torso and allow it to dry completely.
  4. 4Write the date, time, and initials on the outer label of the new patch.
  5. 5Peel off the protective liner, apply the new patch, and press firmly for 30 seconds.

Answer

The correct sequence begins with verifying client identity, followed by removing the old patch while wearing gloves, preparing a new site, labeling the new patch, and finally applying it to the skin.
Safe transdermal medication administration requires strict adherence to a specific procedural sequence. Verifying identity ensures the intervention reaches the correct client. Removing the old patch first (while wearing gloves) prevents toxicity and nurse exposure. Preparing the new site promotes proper absorption and prevents skin breakdown. Labeling the patch prior to application prevents client discomfort from writing pressure. Finally, applying firm pressure secures the patch for its duration of use.

Step-by-Step Solution

1
Verify client identity and perform hand hygiene.
The correct client is confirmed and infection transmission risk is minimized.
This adheres to the basic rights of medication administration and standard safety precautions.
2
Don clean gloves and remove the old fentanyl patch.
The previous medication source is safely discontinued.
Gloves prevent the nurse from absorbing fentanyl dermally, and removing the old patch prevents accidental overdose.
3
Cleanse a new, hairless application site and let it dry.
A fresh area of skin is prepared for the new patch.
Rotating sites prevents skin breakdown. A clean, dry surface ensures the new patch will adhere properly and medication will absorb consistently.
4
Label the new patch with the date, time, and initials.
The patch is clearly marked before it goes on the client's body.
Writing on the patch after application can cause discomfort and may unintentionally push a bolus of medication into the client's tissues.
5
Remove the protective liner, apply to the skin, and press firmly for 30 seconds.
The new fentanyl patch is securely attached and actively delivering medication.
Firm pressure, especially around the edges, ensures the adhesive matrix bonds tightly to the skin for the entire duration of the order.

Key Concept

Safe Administration of Transdermal Medications
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Topics

Pharmacological Therapies

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