A nurse is caring for a client who has a new prescription for a fentanyl transdermal patch. Which of the following actions should the nurse take when administering a transdermal patch? (Select all that apply.)
Apply the transdermal patch to either of the client's forearms.
Remove the old transdermal patch before applying a new one.
Apply the patch to a clean, hairless area of the client's skin.
Use sterile gloves to apply and remove transdermal patches.
Dispose of old transdermal patches in a childproof container.
Correct Answer : B,C,E
A. "Apply the transdermal patch to either of the client's forearms" is incorrect. The nurse should avoid applying the patch to areas with excessive hair, irritation, or broken skin. Common areas include the upper torso (e.g., upper arm, chest, or back).
B. "Remove the old transdermal patch before applying a new one" is correct. To prevent overdose or accidental administration of an additional dose, the nurse should always remove the old patch before applying a new one.
C. "Apply the patch to a clean, hairless area of the client's skin" is correct. This ensures better adhesion and absorption of the medication, as hair and dirt can interfere with the patch's effectiveness.
D. "Use sterile gloves to apply and remove transdermal patches" is incorrect. Standard gloves are sufficient for applying and removing transdermal patches, as they do not need to be sterile.
E. "Dispose of old transdermal patches in a childproof container" is correct. Fentanyl patches should be disposed of properly to avoid accidental exposure or ingestion by children or pets. A childproof container ensures safe disposal.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Measure the client's abdominal girth daily is correct. Ascites is characterized by fluid accumulation in the abdomen. Measuring abdominal girth regularly is important for monitoring changes in the amount of fluid retention and for assessing the progression of ascites. It is a standard nursing intervention for clients with this condition.
B. Keep the client's daily protein intake below 0.8 g/kg is incorrect. Protein intake should not be restricted to this extent. In fact, adequate protein is important for liver health and to prevent muscle wasting in clients with cirrhosis, unless there are complications such as hepatic encephalopathy.
C. Restrict the client's sodium intake to 3 g per day is incorrect. Sodium intake is typically restricted more severely for clients with ascites. The general recommendation is often less than 2 g per day to help prevent fluid retention and reduce the burden on the heart and kidneys.
D. Position the client supine with legs elevated is incorrect. While elevating the legs can help reduce edema in the legs, positioning the client supine does not provide the same benefit for ascites. Side-lying with legs elevated or sitting with the legs elevated may be more beneficial.
Correct Answer is D
Explanation
A. Taking ferrous sulfate on an empty stomach can increase absorption but often causes nausea and gastrointestinal upset. Clients are usually advised to take it with a small amount of food if stomach upset occurs.
B. Drinking more milk does not prevent constipation and can actually decrease the absorption of iron due to calcium content. Adequate fluids and fiber are recommended instead to manage constipation.
C. Black stools are a common and expected side effect of ferrous sulfate due to iron content. Reporting them is not necessary unless accompanied by other concerning symptoms like bleeding or abdominal pain.
D. Mixing ferrous sulfate elixir with a full glass of water helps dilute the medication, reducing irritation to the gastrointestinal tract. It also ensures proper dosing and facilitates easier swallowing of the liquid medication.
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