A nurse is preparing to administer a transdermal patch to a client. The nurse notes the client already has a patch that was applied 24 hr ago. Which of the following actions should the nurse take?

Fold the existing patch on itself and dispose of it in a childproof container.

Shave the client's lower leg for placement of the new patch.

Keep the existing patch on and place the new patch in a different location.

Discard the old patch and apply a new one in the same location.

Answer and Explanation

The Correct Answer is A

A. Fold the existing patch on itself and dispose of it in a childproof container: The nurse should remove the old patch before applying a new one to avoid excessive medication delivery. The patch should be folded on itself to prevent accidental exposure to the medication and disposed of safely in a childproof container to prevent potential harm.

B. Shave the client's lower leg for placement of the new patch: Shaving can irritate the skin and increase the absorption of the medication, leading to an increased risk of side effects. The patch should be applied to clean, dry, and intact skin without shaving the area.

C. Keep the existing patch on and place the new patch in a different location: The old patch should be removed before applying a new one to prevent an overdose of medication. Placing a new patch over an old one can lead to excessive drug absorption,.

D. Discard the old patch and apply a new one in the same location: While the old patch should be discarded, it is not recommended to apply a new patch in the exact same location. Rotating the patch sites is important to prevent skin irritation and promote better absorption.

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Correct Answer is A

Explanation

A. Urine output 25 mL/hr: Urine output less than 30 mL/hr is considered inadequate, especially after surgery. This could indicate possible renal insufficiency or hypovolemia, requiring immediate attention.

B. Heart rate 68/min: A heart rate of 68/min falls within the normal adult range (60-100 beats per minute). This finding is generally considered stable and does not typically indicate an immediate complication requiring urgent reporting to the provider in a postoperative client.

C. Hypoactive bowel sounds: Hypoactive bowel sounds are common in the immediate postoperative period, especially after abdominal surgery. This occurs due to the effects of anesthesia and bowel manipulation.

D. Serosanguineous drainage on surgical dressing: Serosanguineous drainage is typical in the early postoperative period and usually decreases over time. It’s not abnormal unless the amount increases significantly or the drainage becomes purulent.

A. Double-bag the linens. B. Rinse the linens prior to removing them from the client's room. C. Tie the linens' bag securely at the top. D. Wear sterile gloves when handling the linens.

Correct Answer is C

Explanation

A. Double-bag the linens: Double-bagging is no longer a standard requirement unless the outside of the primary bag is visibly soiled or the bag is punctured. Modern infection control guidelines focus on the integrity of a single, sturdy, leak-proof bag to reduce waste and cost.

B. Rinse the linens prior to removing them from the client's room: Rinsing the linens is not required when removing soiled linens. The main concern is preventing contamination, and double-bagging ensures that the linens are safely contained.

C. Tie the linens' bag securely at the top: The primary goal of isolation protocol is to contain the pathogen within the designated "dirty" area. By tying the bag securely, the nurse ensures that no contaminated fluid or air is released as the bag is moved through the hallways of the facility. Standard practice requires placing linens in a leak-proof laundry bag labeled for biohazardous or contaminated materials.

D. Wear sterile gloves when handling the linens: Sterile gloves are not necessary for handling soiled linens in contact precautions. Clean gloves are sufficient to handle linens. Sterile gloves are typically used for invasive procedures, not for routine linen handling.

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A nurse is preparing to administer a transdermal patch to a client. The nurse notes the client already has a patch that was applied 24 hr ago. Which of the following actions should the nurse take?

Nursing Test Bank

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