Editing Pharmacology – LPN Practice Questions (section)

==Question 13==
The nurse is applying a new transdermal fentanyl patch for a client with chronic cancer pain. Which action is essential?
# Apply the new patch directly over the old one for a consistent dose
# Remove the old patch, cleanse the area, apply the new patch to a different site, and document removal of the old patch
# Cut the patch in half if the client reports drowsiness
# Apply the patch to an area of broken or irritated skin so it adheres better

'''Answer:''' 2 (B) Remove the old patch, cleanse the area, apply the new patch to a different site, and document removal of the old patch.

''Rationale:'' Failure to remove the previous patch is a well-documented cause of opioid overdose. Sites are rotated, the skin must be intact, clean, and dry, and removal of the old patch is documented. Option 1 causes stacked dosing. Option 3 is unsafe and can release the entire drug reservoir at once, and a nurse never alters a dose. Option 4 increases absorption unpredictably. Heat sources such as heating pads also increase absorption and must be avoided.