A nurse teaches a caregiver about applying a rivastigmine tr… | MyMerci
Medical EmergenciesPA
Question
A nurse teaches a caregiver about applying a rivastigmine transdermal patch. Which caregiver statement indicates the teaching has been effective?
1"I will leave the patch on for 5 days before changing it."
2"I will remove the previous patch before applying a new one and rotate the site each day."✓ Correct answer
3"I will cut the patch into smaller pieces to titrate the dose."
4"I will apply two patches at once if the first one falls off."
Explanation
Correct (2): The rivastigmine patch is applied once daily; the previous patch must be removed before applying a new one to prevent double-dosing and cholinergic toxicity. Site rotation prevents skin irritation. (1) Two patches simultaneously causes overdose. (3) Cutting destroys the controlled-release matrix. (4) 5-day interval delivers insufficient dose.
In-depth explanation
Memory Tip Rivastigmine patch: "1 patch, 1 day, 1 new site." Document the OLD patch removal — critical safety check.
Clinical scenario
Scenario Caregiver receiving teaching about rivastigmine 9.5 mg/24-hr patch for a parent with Alzheimer disease.
Key concepts
Transdermal patch — Rate-controlled drug delivery through skin; rivastigmine patch reduces GI side effects of oral ChEi.
Patch removal verification — Always confirm and document removal of the previous patch before applying a new one.
Site rotation — Daily change of patch location to prevent skin irritation and ensure consistent absorption.