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Published by: E on Oct 01, 2008
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Generic Name nicotine Peak 2-4 hrs

Trade Name Nicoderm Onset rapid

Clinical Medications Worksheets Classification Dose Smoking deterrent 21mg, 14mg, 7mg

Route TD

Time/frequency 21mg qd 7 days, 14mg qd 7 days, 7mg qd 7 days

Duration unknown

Normal dosage range 21 mg/day for 6 wk, 14 mg/day for 2 wk, then 7 mg/day for 2 wk (10 wk total); system is worn 24 hr For IV meds, compatibility with IV drips and/or solutions N/A Nursing Implications (what to focus on) Contraindications/warnings/interactions Continued smoking Common side effects headache, insomnia, tachycardia, burning at patch site, erythema, pruritus Lab value alterations caused by medicine None known Be sure to teach the patient the following about this medication Explain to patient the necessity of immediate cessation of smoking upon initiation and throughout therapy. Instruct patient in application and use of patch. Apply patch at the same time each day. Keep patch in sealed pouch until ready to apply. Apply to clean, dry skin of upper arm or torso free of oil, hair, scars, cuts, burns, or irritation. Press patch firmly in place with palm for 10 sec, making sure there is good contact, especially around the edges. Keep patch in place during showering, bathing, or swimming; replace patches that have fallen off. Wash hands with plain water after handling patches; soap will increase absorption of nicotine. Do not trim or cut patch. Alternate application sites. Dispose of used patches by folding adhesive sides together and replacing in protective pouch or aluminum foil; keep out of reach of children. Advise patient that redness, itching, and burning at application site usually subside within 1 hr. Instruct patient to notify health care professional and not apply new patch if signs of allergic reaction (urticaria, generalized rash, hives) or persistent local skin reactions (severe erythema, pruritus, edema) occur.

Why is your patient getting this medication Cigarette smoking cessation Mechanism of action and indications (Why med ordered) Provides a source of nicotine during controlled withdrawal from cigarette smoking

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) None known for this patient

Nursing Process- Assessment (Pre-administration assessment) Prior to therapy, assess smoking history (number of cigarettes smoked daily, smoking patterns, nicotine content of preferred brand, degree to which patient inhales smoke). Previous attempts at smoking cessation.

Assessment Why would you hold or not give this med? Signs of toxicity (nausea, vomiting, diarrhea, increased salivation, abdominal pain, headache, dizziness, auditory and visual disturbances, weakness, dyspnea, hypotension, and irregular pulse). Allergic reactions, skin sensitivities.

Evaluation Check after giving Assess patient for symptoms of smoking withdrawal (irritability, drowsiness, fatigue, headache, nicotine craving) periodically during nicotine replacement therapy (NRT). Evaluate progress in smoking cessation periodically during therapy.

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