Clinical Medications Worksheets

Generic Name Trade Name Classification Dose Route Time/frequency

nicotine Nicoderm Smoking deterrent 21mg TD 21mg qd
Peak Onset Duration Normal dosage range
2-4 hrs rapid unknown 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
Why is your patient getting this medication For IV meds, compatibility with IV drips and/or
Cigarette smoking cessation solutions
N/A
Mechanism of action and indications Nursing Implications (what to focus on)
(Why med ordered) Contraindications/warnings/interactions
Provides a source of nicotine during controlled Continued smoking
withdrawal from cigarette smoking
Common side effects
headache, insomnia, tachycardia, burning at patch site,
erythema, pruritus
Interactions with other patient drugs, OTC or Lab value alterations caused by medicine
herbal medicines (ask patient specifically) None known
None known for this patient
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.
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.