Applying Topical Medications

The nurse is preparing to discharge a patient after instructing her in self-application of a topical medication. What is the best way for the nurse to ensure that the patient understands the instructions? A. Discuss with the patient the most common errors in application. B. Review the material several times with the patient and family. C. Allow the patient to apply the topical medication and provide feedback on technique. D. Give the patient printed materials for later reference.

Allow the patient to apply the topical medication and provide feedback on technique. Rationale: Evaluating the patient's ability to apply the medication allows the nurse to critique her technique and correct any mistakes the patient may be making. Discussing the most common errors in application is not the best way for the nurse to follow up. This discussion would have been part of the nurse's earlier patient teaching. Although reviewing the material with the patient and family may be appropriate, it would be more helpful to do so after evaluating the patient's ability to apply the medication. Giving the patient printed materials is generally appropriate; doing so is not the best way to follow up after teaching the patient to apply a topical medication. The nurse must assess and correct any specific errors in the patient's application technique.

The nurse is applying a topical antibiotic and dressing to a burn on the hand of a patient being treated as an outpatient. What is the most important thing the nurse can do to minimize the risk of infection? A. Evaluate the patient's ability to recognize the signs and symptoms of infection. B. Perform effective hand hygiene before and after the application. C. Instruct the patient not to change the dressing between visits. D. Apply the medication using sterile technique.

Apply the medication using sterile technique. Rationale: This is the correct answer. Using sterile technique to perform the dressing change prevents introduction of pathogens during the application of the topical medication. Although evaluating the patient's ability to recognize the signs and symptoms of infection is appropriate, doing so does not address infection prevention. Performing effective hand hygiene and instructing the patient not to change the dressing between visits is appropriate, it is not the best way for the nurse to address infection control for this patient.

Which of the following discharge instructions would be most important in ensuring the safety of a patient who will need to apply a dermal patch daily at home? A. Apply sufficient pressure to the edges of the patch to ensure adequate adherence. B. Avoid using a heating pad on or near the application site. C. Pat the application site dry before applying the patch. D. Reapply the patch to the same site each time to enhance absorption.

Avoid using a heating pad on or near the application site. Rationale: The application of heat will alter and often increase the rate of absorption of the medication. To achieve optimal effectiveness with minimal side effects, the medication must be absorbed at the rate intended by the manufacturer. Although applying pressure to the patch and patting the selected site dry before applying the patch are appropriate, adherence of the patch does not pertain to patient safety. Applying the dermal patch to the same site can cause the skin to become irritated. Rotation of application sites is recommended.

The nurse is preparing to apply a topical oil-based medication to a patient's forearms. What should the nurse do to minimize the risk of contamination during the application? A. Encourage the patient to self-apply the medication. B. Wear treatment gloves during the entire application process. C. Change gloves between prepping the skin and applying the medication. D. Perform effective hand hygiene before and after applying the medication.

Change gloves between prepping the skin and applying the medication. Rationale: Changing gloves minimizes the risk of cross-contamination between the two processes of prepping and application. Encouraging the patient to self-apply the medication will not necessarily minimize contamination. Wearing treatment gloves throughout the application process will not necessarily minimize contamination. Although performing proper hand hygiene is appropriate, it is not the best way to minimize contamination during the application.

Which of the following is not taken into consideration when determining the appropriate amount of a topical medication to be applied to the skin? A. Size of the skin site B. Other medications the patient is taking C. Manufacturer's instructions for application of the product D. Health care provider's order

Other medications the patient is taking Rationale: The nurse would not need to review the patient's other medications, since doing so is unlikely to help the nurse determine how much of a topical medication to use. The nurse's assessment of the size of the skin site is important in determining how much of a topical medication to use. The manufacturer's instructions for applying the topical medication is an important consideration in determining how much of a topical medication to use. The information contained in the health care provider's order is an important consideration in determining how much of a topical medication to use.