Chapter 6: Non Parenteral Medication Administration
6.7 Administering Topical Medications
Critical Thinking Exercises: Questions, Answers, and Sources / References
- Your patient’s MAR states that their Nitro-Patch should be removed at night. Explain why this is considered safe practice.
Answer: nitroglycerine patches release medication fro 7-10 hours. They work best if the body has a “drug-free” period also known as ‘wash out period’ every day. Some patients apply and wear nitro patches during the day and the wash out period is through the night and vice versa.
Source: Mayo Clinic (2019). Nitroglycerine. https://www.mayoclinic.org/drugs-supplements/nitroglycerin-transdermal-route/proper-use/drg-20072959?p=1
2. Discuss the steps you would take to administer a lotion for a patient with a rash that has several open lesions.
Answer:
- Determine the purpose of the lotion and question if it can be used on integument that isn’t intact. Consider consulting the pharmacist.
- wear gloves
- maintain standard precautions when administering topical medications to the skin, mucous membranes, and tissues
- Wash, rinse, and dry the affected area with water and a clean cloth to remove old lotion.
- Place required amount of medication in palm of hands and soften by rubbing palms together.
- if using a cotton tipped applicator, apply ointment, lotion, or cream to it.
Sources: British Columbia Institue of Technology )(BCIT). (2015). In, NURS 1020: Clinical techniques. Vancouver, BC: BCIT
Lilley, L. L., Rainforth Collins, S., Snyder, J. S., Collins, S., & Swart, B. (2016). Pharmacology for Canadian health care practice (3rd ed.). Toronto, ON: Elsevier Canada..
Perry, A., Potter, P., & Ostendorf, W. (2017). Clinical skills and nursing techniques (9th ed.). St. Louis, MO: Elsevier-Mosby.
- When teaching a client about using a nicotine patch to aid with smoking cessation, the nurse should include which of the following advice regarding medications administered by patch: Select all that apply.
| Distractor | Answer | |
| a. | Rotate sites | Correct. Rotating sites lessens risk of skin irritation |
| b. | Applying it to a hairy area will not affect its effectiveness | Incorrect. Patches need to be in contact with the skin to allow absorption of the medication. Hair will interfere with adhesion of the patch) |
| c. | Avoid rashes and / or open skin | Correct. Rashes and open skin can affect absorption. |
| d. | Discard the patch in a biohazard container | Incorrect. Nicotine isn’t a biohazard material nor is it something we have to be concerned with in terms of controlled substances – like we do with fentanyl patches |
Source: Lilley, L. L., Rainforth Collins, S., Snyder, J. S., Collins, S., & Swart, B. (2016). Pharmacology for Canadian health care practice (3rd ed.). Toronto, ON: Elsevier Canada..
