06.03 Topical Medications

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In this video, we’re talking about topical medications. But, specifically, we want to look at administering topical nitro paste. Big thing to know about any topical medication whether it’s a cream or ointment or a patch or something like nitro paste is that you MUST wear gloves. The medication is DESIGNED to absorb through the skin and it WILL absorb through yours, too, if you don’t wear gloves!

So the first thing for any topical medication, especially patches, is to remove the old patch or dosing paper and clean the area.
We always rotate sites, so while you’re at it, choose a new site and clean that site as well.
Now, your nitro paste will be ordered in inches. So let’s say our provider has ordered 1 inch of nitro paste. You’re going to get a sheet of this dosing paper.
As you can see, when you turn it over, you can read the little ruler on the back. So you’ll apply the desired inches of paste/ointment to the back of the dosing paper using that measuring guide.
When you do that if you’re using a packet, open it directly on the dotted line, and just squeeze the packet or the tube gently along the line - you don’t want to glob it on or it’ll be too much.
Now, take the paper, turn it over, and apply it directly to the patient’s skin. Do NOT rub it!
Time/date/initial the paper and secure the paper with tape on at least 2 sides. OR you can use a big Tegaderm or transparent dressing over it. Just make sure you can see the labelling on the paper.


And that’s it - easy as that. Very similar with regular patches - remove the old one, clean your new site, label the patch, and secure it in place.

Be smart, if you’re ever not sure how to apply, check with your pharmacist. Now, go out and be your best self today. And, as always, happy nursing!
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