A nurse is applying a nitroglycerin transdermal patch for a client who has angina. Which of the following actions should the nurse take?
Apply the patch to a hairless area of the skin.
Apply a 4x4 dressing over the patch.
Apply the patch to the same site every 24 hr.
Apply the patch to a bony prominence on the chest.
The Correct Answer is A
Choice A Reason:
Apply the patch to a hairless area of the skin is correct. Nitroglycerin patches should be applied to a clean, hairless area of the skin to ensure proper absorption of the medication. Hair can interfere with the patch's adherence and the absorption of nitroglycerin into the bloodstream. The site chosen should be rotated to prevent skin irritation or tolerance development. Commonly used areas include the chest, upper arms, or torso, but it's important to follow specific instructions provided by the healthcare provider.
Choice B Reason:
Apply a 4x4 dressing over the patch is incorrect. Covering the nitroglycerin patch with a dressing may interfere with its absorption and effectiveness. These patches are designed to be applied directly to the skin without covering.
Choice C Reason:
Apply the patch to the same site every 24 hr is incorrect. Repeatedly applying the patch to the same site increases the risk of skin irritation or tolerance to the medication. It's crucial to rotate patch sites to avoid these issues.
Choice D Reason:
Apply the patch to a bony prominence on the chest is incorrect. Nitroglycerin patches should not be placed on bony prominences because these areas can be uncomfortable and may not provide optimal absorption. Instead, they are typically applied to relatively flat, hairless areas of the skin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Withdrawing the NPH insulin from the vial should come after injecting air into the NPH vial.
Choice B Reason:
Injecting air into the regular insulin vial should occur after withdrawing the NPH insulin from its vial.
Choice C Reason:
Inject air into the NPH vial is correct. The sequence for mixing regular insulin (clear) and NPH insulin (cloudy) in the same syringe typically involves injecting air into the NPH (cloudy) insulin vial first. This step prevents excess pressure buildup when withdrawing the solution, making it easier to draw the correct amount of NPH insulin into the syringe.
Choice D Reason:
Withdrawing the regular insulin from the vial should occur after withdrawing the correct amount of NPH insulin into the syringe.
Correct Answer is D
Explanation
Choice A Reason:
Decrease the dose of the medication is incorrect. Lowering the dose could potentially drop the INR below the therapeutic range, increasing the risk of clot formation.
Choice B Reason:
Increase the dose of the medication is incorrect. Raising the dose might push the INR above the therapeutic range, increasing the risk of bleeding.
Choice C Reason:
Withhold the medication is incorrect. Withholding the medication might lead to inadequate anticoagulation and an increased risk of clot formation.
Choice D Reason:
Administer the current dose of the medication. An INR of 2.5 is within the therapeutic range for many indications, including atrial fibrillation. This means the blood is appropriately anticoagulated to prevent clot formation without an excessive risk of bleeding. In this scenario, maintaining the current dose of warfarin is often appropriate to sustain the desired therapeutic effect.
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