Always ask patients about transdermal patches
Always ask patients about transdermal patches
All patients should be asked about any medication, prescribed or over-the-counter, that they are taking, including transdermal patches, says Cindy Vanek, MS, RN, director of emergency and critical care services at Indian River Medical Center in Vero Beach, FL.
"Symptoms can be due to side effects, interactions, omissions, or overdoses, so the initial list of medications is a critical piece of information," says Vanek. To avoid missing transdermal patches:
- Assess the patient's skin integrity and look for bumps, bruises, abrasions, wounds, needle marks, and transdermal patches.
"Patches are fairly common, and there are many types, from fentanyl for pain to nitroglycerin for cardiac patients to birth control or nicotine," Vanek says. "That's why a complete medication history is so important — any of these can have implications for diagnosis and treatment."
- Consider fentanyl overdoses whenever a patient presents with a change in mental status and respiratory depression.
"It's more important to do the assessment and give a narcotic reversal agent as quickly as possible than to know the exact drug taken," says Vanek.
The use of fentanyl patches is commonly used to treat chronic moderate to severe pain, but like all medications, it can have serious side effects. "This year, there have been multiple recalls of the patch due to leakage, which results in too much drug being delivered and an overdose," says Vanek. "Several deaths have been reported."
- Before applying a new transdermal patch, always check patients for patches already in place — not only fentanyl, but also others such as lidocaine.
Diane Cousins, RPh, vice president of healthcare quality and information for U.S. Pharmacopoeia, says, "If the patient is transferred from the ED to another unit, communication of medications, past and present, must be foremost in the nurse's mind when providing a report on the patient."
All patients should be asked about any medication, prescribed or over-the-counter, that they are taking, including transdermal patches, says Cindy Vanek, MS, RN, director of emergency and critical care services at Indian River Medical Center in Vero Beach, FL.Subscribe Now for Access
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