A nurse is preparing to administer nitroglycerin topical ointment to a client. Which of the following actions should the nurse plan to take?
A.
Measure the dosage of medication using the applicator paper.
B.
Spread the medication over a 12.7 cm (5 in) area of the client’s skin.
C.
Cover the medication on the client’s skin with a sterile gauze pad.
D.
Apply the medication to the same site for three consecutive days.
The Correct Answer and Explanation is:
The correct answer is A. Measure the dosage of medication using the applicator paper.
Explanation:
Nitroglycerin topical ointment is used to manage angina pectoris by delivering a controlled dose of nitroglycerin through the skin. The application process is crucial to ensure efficacy and prevent complications. Here’s a detailed explanation of the correct and incorrect actions:
- Measure the dosage of medication using the applicator paper (A):
- Rationale: Nitroglycerin ointment should be applied in precise amounts, usually measured in inches or centimeters. Applicator paper or a specific dosing paper is often provided with the medication to ensure accurate measurement. The correct dose is measured using this paper and then applied to the client’s skin. This method avoids contamination and ensures the correct amount of medication is used, which is crucial for achieving the desired therapeutic effect and minimizing side effects.
- Spread the medication over a 12.7 cm (5 in) area of the client’s skin (B):
- Rationale: The nitroglycerin ointment should not be spread over a large area. Typically, the medication is applied in a narrow strip, and the area of application is not specified in terms of size but rather in terms of the length of the strip (e.g., 1 inch or as prescribed). Spreading it over a large area could lead to overdosage and systemic effects.
- Cover the medication on the client’s skin with a sterile gauze pad (C):
- Rationale: Covering the medication with gauze is not recommended. Nitroglycerin ointment should be applied directly to the skin, and covering it can interfere with its absorption. Additionally, the medication needs to be in direct contact with the skin to be effective.
- Apply the medication to the same site for three consecutive days (D):
- Rationale: Applying nitroglycerin to the same site repeatedly can cause skin irritation and reduce its effectiveness due to tolerance development. It is generally recommended to rotate the application sites to minimize these issues. Using different sites helps prevent skin reactions and ensures the effectiveness of the medication.
In summary, A is the correct action because it ensures precise dosing using the provided applicator paper, which is crucial for safe and effective nitroglycerin administration.