Page 1783 - Saunders Comprehensive Review For NCLEX-RN

7. Topical ointments
a. Instruct the client to remove the ointment on the skin
from the previous dose.
b. Instruct the client to squeeze a ribbon of ointment of
the prescribed length onto the applicator or dose-
measuring paper.
c. Instruct the client to spread the ointment over a 2.5- by
3.5-inch (6.5 by 9 cm) area and cover with plastic
wrap, using the chest, back, abdomen, upper arm, or
anterior thigh (avoid hairy areas).
d. Instruct the client to rotate sites and to avoid

touching the ointment when applying.
8. Patches and ointments
a. Wear gloves when applying.
b. Do not apply on the chest in the area of defibrillator-
cardioverter pad placement, because skin burns can
result if the pads need to be used.

Instruct the client using nitroglycerin tablets to check the

expiration date on the medication bottle, because expiration may occur
within 6 months of obtaining the medication. The tablets will not relieve
chest pain if they have expired.
XI. β-Adrenergic Blockers (Box 53-14)
A. Description
1. β-Adrenergic blockers inhibit response to β-adrenergic
stimulation, thus decreasing cardiac output.
2. They block the release of catecholamines, epinephrine,
and norepinephrine, thus decreasing the heart rate
and BP; they also decrease the workload of the heart
and decrease oxygen demands.
3. Used for angina, dysrhythmias, hypertension,
migraine headaches, prevention of myocardial
infarction, and glaucoma
4. β-Adrenergic blockers are contraindicated in the client
with asthma, bradycardia, heart failure (with
exceptions), severe renal or hepatic disease,
hyperthyroidism, or stroke; carvedilol, metoprolol,
and bisoprolol have been approved for use in heart
failure once the client has been stabilized by ACE
inhibitor and diuretic therapy.
5. β-Adrenergic blockers should be used with caution in
the client with diabetes mellitus, because the
medication may mask symptoms of hypoglycemia.
6. β-Adrenergic blockers should be used with caution in
the client taking antihypertensive medications.

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