A nurse is preparing to administer nitroglycerin topical ointment to a client. Which of the following actions should the nurse plan to take?
Measure the dosage of medication using the applicator paper.
Spread the medication over a 12.7 cm (5 in) area of the client's skin.
Cover the medication on the client's skin with a sterile gauze pad.
Apply the medication to the same site for three consecutive days.
The Correct Answer is B
Choice A Reason:
Using the applicator paper is appropriate for measuring the dosage accurately, but simply measuring the dosage is not the only step; the medication needs to be spread over the specified area of the skin.
Choice B Reason:
Spread the medication over a 12.7 cm (5 in) area of the client's skin. Nitroglycerin ointment is typically measured using a specific paper or measuring tape provided with the medication to ensure accurate dosing. The ointment is spread thinly and evenly over a specific measured area of the skin, usually about 12.7 cm (5 inches) in length, to maintain consistent dosing.
Choice C Reason:
Covering the medication with a sterile gauze pad is not typically done with nitroglycerin ointment. The ointment is meant to be absorbed through the skin, and covering it may interfere with its absorption.
Choice D Reason:
Nitroglycerin ointment is often applied to different sites to prevent skin irritation and tolerance from developing at one site. It's usually rotated to different clean areas of the skin to prevent skin irritation and tolerance buildup. Applying it to the same site for three consecutive days is not standard practice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Increase in serum glucose is incorrect. Desmopressin, which is a synthetic form of vasopressin, primarily affects water reabsorption in the kidneys and doesn't directly impact glucose levels. Therefore, an increase in serum glucose wouldn't be an expected therapeutic response to desmopressin for diabetes insipidus.
Choice B Reason:
Decrease in blood pressure is incorrect. Desmopressin is primarily used for its antidiuretic effect, concentrating urine by increasing water reabsorption in the kidneys. It typically doesn't have a significant impact on blood pressure. Therefore, a decrease in blood pressure wouldn't typically be an anticipated therapeutic response to desmopressin in this context.
Choice C Reason:
Decrease in urine output is correct. Desmopressin is a synthetic form of vasopressin (antidiuretic hormone) used to treat diabetes insipidus, a condition characterized by excessive urination and extreme thirst due to the inability to concentrate urine. The primary goal of desmopressin is to reduce urine output by increasing water reabsorption in the kidneys, thereby decreasing excessive urination. Therefore, a decrease in urine output would indicate a therapeutic response to the medication in this context.
Choice D Reason:
Increase in WBC count is incorrect. Desmopressin's action is centered on affecting kidney function by regulating water reabsorption and does not involve changes in white blood cell count. Consequently, an increase in WBC count wouldn't be an expected therapeutic response to desmopressin for diabetes insipidus.
Correct Answer is A
Explanation
Choice A Reason:
Rotate the application site every week is correct. Rotating the application site is essential to prevent skin irritation or sensitization. Advising the client to apply the patch to a different area of clean, dry, non-hairy skin each time helps reduce the risk of skin irritation at the application site.
Choice B Reason:
The transdermal patch can cause insomnia is incorrect. Insomnia is a potential side effect of nicotine replacement therapy (NRT) patches, including transdermal nicotine patches, but it's not a universal side effect for everyone using the patch.
Choice C Reason:
Leave the patch in place for 8 hr. each day is incorrect. Transdermal nicotine patches are typically worn for 16–24 hours each day, depending on the specific product instructions. Leaving the patch on for a shorter duration might reduce its effectiveness in supporting smoking cessation.
Choice D Reason:
The transdermal patch releases nicotine rapidly into the bloodstream is incorrect. Transdermal nicotine patches deliver nicotine slowly through the skin into the bloodstream over an extended period rather than providing a rapid release. This gradual release helps reduce cravings and withdrawal symptoms associated with smoking cessation.
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