A client has an order for a nitroglycerin transdermal patch. The best way to ensure proper administration of this medication is to:
apply it behind the ear.
place it over a hairy skin area.
rotate sites to avoid skin irritation.
put the initials on patch when applied.
The Correct Answer is C
A) Apply it behind the ear: This option is not correct. Nitroglycerin patches are typically applied to hairless areas of the skin to ensure proper adhesion and absorption. The preferred locations are usually the chest, upper arm, or thigh.
B) Place it over a hairy skin area: This action is inappropriate as hair can interfere with the adhesion of the patch and may affect absorption. It is essential to apply the patch to a clean, dry, and hairless area for optimal effectiveness.
C) Rotate sites to avoid skin irritation: This is the correct action. Rotating the application site helps prevent skin irritation and allows for better absorption of the medication. It also reduces the risk of sensitization or reaction at any one site.
D) Put the initials on the patch when applied: While documenting the application is important, simply putting initials on the patch is not sufficient for ensuring proper administration. It is more crucial to ensure that the patch is applied correctly, and monitoring for skin integrity and effectiveness should be part of the nursing care plan.
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Correct Answer is C
Explanation
A) 6 weeks from the start of using the inhaler: This option is not accurate. The timing for refilling should be based on the actual usage rather than a fixed period, and 6 weeks may not align with the client’s actual consumption.
B) As soon as the client leaves the hospital: This option is premature. The client does not need to refill the inhaler immediately upon discharge since they may not have used many puffs yet.
C) 50 days after discharge: This is the correct answer. If the client is to administer 2 puffs twice daily, that totals 4 puffs per day. With 200 puffs in the inhaler, the inhaler would last for 50 days (200 puffs ÷ 4 puffs per day = 50 days). Advising the client to refill the medication approximately 50 days after discharge ensures they have enough medication available.
D) When the inhaler is half empty: This option could lead to refilling too early or too late, depending on the individual’s usage pattern. Advising to refill based on a specific number of days or puffs used provides a more precise recommendation.
Correct Answer is C
Explanation
A) A client who has a question about her daily medications: While it's important to address questions regarding medications, this client does not present an immediate clinical concern that requires urgent attention.
B) A client who needs discharge teaching about an antibiotic: Although discharge teaching is important, it is not an immediate priority compared to the potential instability of a client with chest pain.
C) A client who just received nitroglycerin for chest pain: This is the correct choice. A client who has received nitroglycerin needs to be closely monitored for its effects, including blood pressure and relief of chest pain. This situation is potentially critical, making it the highest priority for assessment.
D) A client who would like some acetaminophen (Tylenol) for a mild headache: While this request should be addressed, it is not as urgent as the need to assess the client who has recently received nitroglycerin. Managing a mild headache is less critical compared to monitoring a client with chest pain.