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Difficulty: MediumPharmacological Therapies

A client with stable angina is prescribed a daily nitroglycerin transdermal patch. Place the following steps for applying the patch in the correct sequential order. (Move the steps into the correct order, starting with the first action.)

  1. 1Perform hand hygiene and put on clean gloves.
  2. 2Remove the previously applied patch and fold it in half with the adhesive sides together.
  3. 3Cleanse and dry a new, hairless application site on the upper chest, back, or upper arm.
  4. 4Write the current date, time, and your initials on the outside of the new patch.
  5. 5Apply the new patch to the prepared skin site, pressing firmly to ensure adherence.

Answer

The correct sequence is: put on gloves, remove the old patch, clean and dry a new site, label the new patch, and apply the new patch.
The correct sequence strictly adheres to safety protocols for transdermal medication administration. It begins with self-protection (gloves), prioritizes client safety by preventing overdose (removing the old patch), ensures optimal drug delivery (cleaning a new site), establishes accurate communication (labeling), and concludes with the actual administration (applying the patch).

Step-by-Step Solution

1
Put on clean gloves.
The nurse's hands are protected.
Nitroglycerin is readily absorbed through the skin and can cause adverse effects like headaches or hypotension in the nurse if handled with bare hands.
2
Remove the old patch and discard it properly.
The continuous delivery of the previous dose is stopped.
Failing to remove the old patch before applying a new one can lead to nitroglycerin toxicity and severe hypotension.
3
Cleanse and dry a new site.
A fresh, hairless area is prepared for the new medication.
Site rotation prevents skin breakdown, and a clean, dry surface is required for the adhesive to stick securely.
4
Label the new patch with date, time, and initials.
The patch is properly identified.
Labeling provides a clear timeline for medication administration and ensures the next nurse knows when the patch is due for removal.
5
Apply the new patch firmly to the skin.
The medication delivery process begins.
Pressing the patch firmly ensures it adheres fully and delivers the correct therapeutic dose.

Key Concept

Safe administration of transdermal medications requires protecting the nurse from exposure, preventing client toxicity by removing prior doses, and ensuring proper site rotation and documentation.
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Topics

Pharmacological Therapies

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