To ensure safety while administering a nitro-glycerine patch, the nurse should?

DHS Staff Nurse - 2018 (Shift-2nd)

Fundamental of Nursing

Easy

Appeared in: DHS Staff Nurse - 2018 (Shift-2nd)

Explanation

Wearing gloves is the most critical safety measure to prevent the nurse from accidentally absorbing the nitroglycerin through their own skin.
Nitroglycerin is a potent vasodilator; direct contact can cause systemic side effects in the caregiver, including severe headaches, dizziness, and a sharp drop in blood pressure (hypotension).
This is a fundamental standard precaution for applying any potent topical medication.

Option B: Shaving the area creates micro-abrasions on the skin. This breaks the skin barrier and can lead to excessive and rapid absorption of the medication, increasing the risk of adverse effects for the patient.
Option C: Using hot water to wash the skin causes local vasodilation (widening of blood vessels). This significantly increases the rate of drug absorption from the patch, which can lead to sudden hypotension and other adverse effects.
Option D: The buttocks are not a recommended application site. Absorption can be inconsistent, and the patch may be more easily dislodged by clothing and sitting.

Clinical Relevance

Nursing practice connection: Knowing Safe administration of transdermal nitroglycerin patch helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Protecting oneself from medication exposure is a fundamental principle of nursing safety. Accidental absorption of potent drugs like nitroglycerin can incapacitate the nurse and compromise patient care.
Patient education is a key nursing responsibility. The nurse must teach the patient and their family the correct application procedure, including the importance of site rotation and safe disposal of used patches, to ensure therapeutic effects and prevent accidents at home.
What if? If the patient has a fever or is using an external heat source like a heating pad or electric blanket, the nurse must monitor the patient closely for signs of hypotension (dizziness, lightheadedness). Heat increases the rate of drug absorption from the patch, raising the risk of an overdose.

How to Approach the Question

First, identify the core of the question: it asks for a key safety measure during the administration of a nitroglycerin patch.
Recall the properties of nitroglycerin: it's a potent vasodilator that is absorbed transdermally (through the skin).
Consider the implications for the person applying the patch. Direct skin contact would lead to drug absorption and potential side effects for the nurse.
Evaluate each option based on this principle and standard medication administration procedures:
Option A (Wear gloves): This directly prevents skin contact and protects the nurse. This is a critical safety measure.
Option B (Shave): Shaving damages the skin barrier, which would increase, not control, absorption, making it unsafe.

Concept Tested & Keywords

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E6 Pharmacology Nursing Lilley 11e Part 1 p. 150-152

E6 Pharmacology Nursing Lilley 11e Part 2 p. 64-66