Transdermal Medication Administration (Nursing)

00:04 So let's take a look at the skill transdermal medication administration.

00:09 So when we're talking about transdermal this is going to look a lot like our patches. So particular patches you may use as a nursing student or apply as a nurse is going to be a popular one, nicotine patches for example your patient may be ordered that. Also commonly we use pain patches to help with relieving pain in chronic pain patients.

00:30 So this may look like a lidoderm patch for example, or a fentanyl patch. So when we go give a transdermal medication, what are we going to need.

00:40 First of all the medication itself and also gloves to apply it.

00:44 So let's take a minute to look at this specific medication delivery system.

00:48 It's a really neat medication system for the reason that it's pretty no mess. You put on a patch of medication that usually adheres to the patient's skin. Also, this medication delivers a slow delivery of a certain amount of drug over a specific amount of time.

01:06 So, for instance, you may have a patch on for only 24 hours, or you may have a pain patch on for your patients or administer this that lasts 72 hours. So there's different variations of transdermal patches. But no, this is a really unique delivery system for medications.

01:27 So before you go give that transdermal medication, what do you need to remember.

01:31 Don't forget those seven rights of medication administration.

01:35 Really important. We're giving that right patch to the right patient.

01:39 So once we check those rights we want to make sure we look at that application site and make sure that skin is intact.

01:47 So some of these drugs in the transdermal system, if we put it on a broken piece of skin, can be very irritating to the patient.

01:55 So make sure to assess the site itself.

01:58 Now when I apply a transdermal medication, I always wear gloves.

02:03 The reason why I do this there could be pain medication.

02:07 There could also be something like nitroglycerin, which can help with chest pain on a patient.

02:12 And I do not personally want to absorb that as a nurse.

02:16 So if necessary, we may need to clean that side off.

02:20 Using soap and water and really just kind of pat that area dry before we give the medication that way absorbs much better into the skin.

02:29 Now at this point we may need to perform hand hygiene and replace those gloves if indicated. Now we can open our patch itself and remove it. And note each patch is a little bit different.

02:41 We need to see the side that is supposed to be placed on the patient.

02:45 So note that on your package.

02:47 One key note to keep in mind about transdermal is once you put on a patch for a medication, typically we have to replace that patch.

02:57 Here's a great example.

02:59 Someone that's receiving a nicotine patch will be placed at maybe one day at 7 a.m.. Now the new shift the next day.

03:07 Since it's a 24 hour patch, we'll need to make sure we find that patch from yesterday and remove it so we're not overdosing the patient on medication.

03:16 Document where the old patch was removed and determine a different spot for the new patch. The patches need to be rotated to prevent skin irritation and breakdown. Taking a look at special considerations for a transdermal medicine, one thing we don't want to do with a transdermal med is to put it on skin that's not intact or broken skin.

03:37 This can be really irritating to the patient.

03:40 Next, we need to remember that transdermal patches typically have medications still in them. We do not put these in the trash.

03:48 Let me repeat we do not put these in the trash.

03:52 Transdermal medications can come in the type of meds such as fentanyl or maybe lidoderm or lidocaine, something like that, like a pain patch. And we do not want to leave these in the trash.

04:03 These are supposed to be disposed of appropriately.

04:07 We do want to keep note that remember, remove that old patch before you put the new one on, because otherwise you don't want the patient looking like polka dots and having several patches all over their body.

04:19 That just means all of that drug is getting absorbed to their system, and that is not what we want for our patient.

04:26 So a great tip is when you do a transdermal medication administration, it's really a good idea to date and time that application.

04:35 So the new nurse knows when they come on shift that oh here's the patch from yesterday. This was placed on there.

04:42 So that's really helpful in communication of care.

04:46 Also we want to take that patch and dispose of it properly.

04:50 Now every facility is a little bit different about this.

04:53 We just want to remember we do not put that in the trash.

04:56 So some of your facilities may say because there's drug on that patch that we want to take that patch and put it in something we call like a black box, for example, for proper disposal of that medication patch.