A nurse is providing teaching to a client who has a new prescription for nitroglycerin transdermal patch. Which instructions should the nurse include? Select 4 that apply

A. Apply the patch to a hairless area: Hair can interfere with patch adhesion and medication absorption. Applying the patch to a clean, dry, hairless area such as the upper chest or arm promotes effective drug delivery. B. Take the old patch off, clean skin, and apply a new patch each day: Proper skin hygiene before reapplication helps prevent irritation and ensures consistent medication absorption. Old patches must be removed to avoid overdose or skin reactions. C. Gloves are not needed for application of the patch: Gloves should always be worn when handling nitroglycerin patches to prevent the nurse from absorbing the medication through the skin, which could lead to hypotension or headache. D. A nitrate-free period, typically at bedtime, is needed to prevent tolerance: Continuous exposure to nitrates can lead to tolerance. A daily nitrate-free interval of 10–12 hours allows the body to maintain responsiveness to the medication over time. E. Apply a new patch at the onset of anginal pain: Transdermal nitroglycerin is used for angina prevention, not for acute relief. Sublingual tablets or sprays are used to manage sudden chest pain episodes, not patches. F. Rotate patch sites: Rotating sites reduces the risk of skin irritation and enhances medication absorption. Using the same site repeatedly can cause local inflammation or reduce effectiveness.