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Difficulty: EasyPharmacological Therapies

While providing care for a client with chronic angina, a practical nurse prepares to apply a new transdermal nitroglycerin patch. Place the following nursing actions in the correct chronological sequence.

  1. 1Perform hand hygiene and put on clean gloves.
  2. 2Remove the old patch and fold it in half with the adhesive sides together.
  3. 3Clean and dry the skin area where the old patch was located.
  4. 4Select a new, intact, and hairless site on the client's upper body.
  5. 5Apply the new patch and document the date, time, and initials on it.

Answer

The correct chronological sequence is: perform hand hygiene and put on gloves, remove the old patch, clean the old site, select a new site, and finally apply and label the new patch.
Administering a transdermal patch requires strict adherence to safety protocols for both the client and the nurse. The nurse must first protect themselves by donning gloves. Next, the old patch must be removed and the area cleansed to prevent an accidental overdose from residual medication. Finally, site rotation is practiced by selecting a new, hairless area before applying and labeling the new patch.

Step-by-Step Solution

1
Perform hand hygiene and put on clean gloves.
The nurse's hands are protected from inadvertent medication absorption.
Transdermal medications are easily absorbed through the skin. The nurse must protect themselves before handling the medication or the client's old patch.
2
Remove the old patch and fold it in half with the adhesive sides together.
The old medication source is safely removed and contained.
Leaving an old patch on while applying a new one can cause a dangerous overdose, leading to severe adverse effects such as profound hypotension.
3
Clean and dry the skin area where the old patch was located.
The previous application site is free of residual medication.
Residual medication left on the skin can continue to be absorbed if not washed away.
4
Select a new, intact, and hairless site on the client's upper body.
A safe and effective location is identified for the new dose.
Site rotation prevents skin breakdown and irritation while ensuring predictable medication absorption.
5
Apply the new patch and document the date, time, and initials on it.
The medication is administered and the action is clearly communicated.
Labeling the patch informs other nurses when the patch was placed and when it is due for removal or replacement.

Key Concept

Safe Administration of Transdermal Medications
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Topics

Pharmacological Therapies

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