A nurse is preparing to apply a transdermal nicotine patch for a client. Which of the following actions should the nurse take?

Apply the patch within 1 hr of removing it from the protective pouch.

Shave hairy areas of skin prior to application.

Wear gloves to apply the patch to the client's skin.

Remove the previous patch and place it in a tissue.

Answer and Explanation

The Correct Answer is C

A.   Transdermal nicotine patches should be applied immediately after removal from the protective pouch, but waiting for up to 1 hour is acceptable according to most manufacturers' instructions.
B.   Shaving hairy areas of skin is not necessary prior to applying a transdermal nicotine patch and may cause skin irritation.
C.   Wearing gloves during the application of the transdermal nicotine patch helps to prevent nicotine absorption through the nurse's skin and reduces the risk of accidental exposure.
D.   The nurse should properly dispose of the previous patch according to facility protocols rather than placing it in a tissue, as used nicotine patches can still contain active medication and pose a risk of exposure.

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Correct Answer is C

Explanation

A. Circulatory overload is characterized by symptoms such as dyspnea, crackles, and increased blood pressure, rather than localized redness and warmth.
B. Extravasation refers to the leakage of IV fluid into surrounding tissue, causing swelling and pain.
C. Redness and warmth around the peripheral catheter insertion site are indicative of phlebitis, which is inflammation of the vein. It's essential to document this finding accurately to monitor for worsening or complications.
D. Infiltration occurs when IV fluid leaks into the surrounding tissue, but it typically presents with swelling, pallor, and coolness at the site rather than redness and warmth.

A. "Do you need information on hospice care?" B. "Would you like to talk to a counselor about advance directives?" C. "Would you like to speak to a spiritual advisor?" D. "Do you need a prescription for an antianxiety medication?"

Correct Answer is C

Explanation

A. While hospice care may be appropriate for the client, it does not directly address the client's reported depression.
B. Discussing advance directives is important for end-of-life care planning, but it may not address the client's current emotional needs.
C. Offering spiritual support acknowledges the client's emotional distress and provides an opportunity for comfort and guidance that aligns with the client's values and beliefs.
D. Offering medication without further assessment or exploration of the client's feelings may not be the most therapeutic response to the reported depression.

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A nurse is preparing to apply a transdermal nicotine patch for a client. Which of the following actions should the nurse take?

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