Exelon patch falls off?

[mickey00minne]

Hello Everyone,

I am a new grad and working at a LTC nursing home currently. It happened a few days ago during my evening shift, my resident's PSW told me that resident's exelon patch was missing. The old exelon patch was applied at 0800 in the morning and should be removed by next day's 0800. It was only about 2100h at that time so I just re applied a new patch to my resident right away. The next day, the nurse works days shift told me I should not do that without a doctor's order because we dont know what much the dose has been released. So it is really necessary to call the doctor to obtain a order to apply a new exelon patch if it falls off by accident? The same as Nitro Patch ??

[Peanut&Buttercup]

Well, I have no clue as to whether you should have called the provider, but I found on Exelon's website instructions on what to do if the patch falls off:

Exelon Patch is designed to deliver medication during the time it is worn. If your loved one's Exelon Patch falls off before its usual replacement time, put a new patch on right away.

Treat Alzheimer's | Exelon® Patch (rivastigmine transdermal system)

[caroladybelle, BSN, RN]

Most patches are designed to release a set amt of medication continuously. If the pt is getting the med 24/7, one should replace the patch as soon as it falls off / or the absence is noted.

[loriangel14, RN]

If the patch is chronically falling off you can cover it iwth a Tegaderm.

[nurseprnRN, BSN, RN]

If you change it now, you can pull it off in the morning and replace it on schedule. The drug has been continuously delivered at a constant rate in either case, right? Come to that, the drug would be delivered in a constant fashion if you took it off and put on a new one every hour (not that this would be likely to occur, and wasteful besides). The nurse who told you to get a new order doesn't understand how this drug delivery system works, and hasn't read the drug info sheet about "replace it right away."

Try putting it somewhere the patient won't see it or pick at it (back of the upper arm, back), and cover c Tegaderm or the like.