The nurse teaches a client who is starting a transdermal nitroglycerin patch for prevention of angina. Which statement shows correct understanding?
1I will wear each patch continuously for 24 hours so that the antianginal effect does not fall overnight.
2I will apply an extra patch when chest pain begins because the transdermal form acts rapidly during an attack.
3I will place each new patch on the same hairy chest area because repeated use improves absorption.
4I will follow the prescribed daily patch-on period and 10-to-12-hour patch-free interval and rotate skin sites.✓ Correct answer
Explanation
Continuous nitrate exposure promotes tolerance. A common transdermal schedule uses a patch-on period of 12 to 14 hours followed by a patch-free interval of 10 to 12 hours, as prescribed. Application sites are rotated on clean, dry skin. Transdermal nitroglycerin prevents angina but does not act rapidly enough to treat an acute attack, which requires the client's prescribed rescue plan.
Clinical reasoning A daily nitrate-free interval restores responsiveness and helps prevent loss of antianginal effect. Site rotation also reduces local skin irritation.
Decision rule Use the patch on the prescribed intermittent schedule, remove the old patch before applying a new one, rotate sites, and use the prescribed rapid-acting strategy for acute chest pain.