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    HESI RN pharmacology proctored exam

    When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. Which action should the nurse take?

    Explanation & Rationale

    A. Administer an oral analgesic and evaluate its effectiveness before applying the new patch: There is no need to switch to oral analgesics if the client is already well-managed on a fentanyl patch. The focus should be on properly managing the patch schedule rather than changing the route of administration.B. Apply the new patch in a different location after removing the original patch: Proper protocol for transdermal patches includes removing the old patch before applying a new one to prevent overdose. The new patch should be placed on a different skin site to avoid skin irritation and ensure even drug absorption.C. Place the patch on the client's shoulder and leave both patches in place for 12 hours: Leaving both patches in place can lead to dangerously high serum fentanyl levels and significant respiratory depression. Only one patch should be used at a time unless otherwise specifically prescribed.D. Remove the patch and consult with the healthcare provider (HCP) about the client's pain resolution: It is unnecessary to contact the HCP immediately if the client is pain-free and the scheduled time for patch replacement has arrived. Standard procedure should be followed by simply removing the old patch and applying the new one.

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