A nurse is caring for a client who has a new prescription for a nitroglycerin transdermal patch. Which of the following actions should the nurse take?

Take the patch off prior to bathing the client.

Monitor for hypertension after application of the patch.

Rotate the application sites of the patch.

Remove the patch every 24 hr.

Answer and Explanation

The Correct Answer is C

A. Take the patch off prior to bathing the client: It is unnecessary to remove the patch before bathing. The patch is waterproof and designed to stay on during such activities.
B. Monitor for hypertension after application of the patch: Hypotension, not hypertension, is a potential side effect of nitroglycerin due to vasodilation. Monitoring for hypotension is essential.
C. Rotate the application sites of the patch: Rotating application sites prevents skin irritation and ensures proper absorption of the medication.
D. Remove the patch every 24 hr: Nitroglycerin patches are typically removed for 10-12 hours each day to prevent tolerance but not necessarily at 24-hour intervals.

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Correct Answer is A

Explanation

A. Use the Z-track technique to administer the medication.: The Z-track technique prevents irritation by sealing the medication within the muscle tissue.
B. Administer the medication with a 27-gauge 1/2-inch needle.: IM injections require a longer needle, typically 1–1.5 inches, and a larger gauge, such as 21–25.
C. Inject the medication at least 5 cm (2 in) from the umbilicus.: This is relevant for subcutaneous injections, not IM injections.
D. Give the medication without aspirating prior to injection.: Aspiration is not always required for IM injections but is often practiced for safety when administering certain medications.

A. "Contact the provider if you experience unexplained muscle pain." B. "Take the medication at bedtime." C. "Discard excess medication after 60 days." D. "Inject the medication into the subcutaneous tissue of your abdomen."

Correct Answer is D

Explanation

A. "Contact the provider if you experience unexplained muscle pain.": Muscle pain is not a typical adverse effect of exenatide; this advice would apply to statins or drugs associated with rhabdomyolysis.
B. "Take the medication at bedtime.": Exenatide is usually taken twice daily, 1 hour before morning and evening meals, not at bedtime.
C. "Discard excess medication after 60 days.": Exenatide pens should typically be discarded 30 days after opening, not 60 days.
D. "Inject the medication into the subcutaneous tissue of your abdomen.": Correct. Exenatide is administered subcutaneously, typically in the abdomen, thigh, or upper arm.

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Prescribed Medication	Nursing Instruction
Albuterol	"Take your albuterol when you are having difficulty breathing.” "Hold your breath for 20 seconds when taking your albuterol.”
Salmeterol	"Take the salmeterol 5 minutes before the albuterol when you need both medications." "Take the salmeterol 2 times each day."
Fluticasone	"Rinse out your mouth after taking the fluticasone." "Take the fluticasone as needed for an asthma attack."

A nurse is caring for a client who has a new prescription for a nitroglycerin transdermal patch. Which of the following actions should the nurse take?

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