When using a transdermal nitroglycerin patch, what instruction is crucial for the client?

When using a transdermal nitroglycerin patch, the instruction to remove the patch for 12 to 14 hours a day is essential to prevent tolerance to the medication. Continuous exposure to nitroglycerin can lead to diminished effectiveness, meaning that the body may become accustomed to the drug, requiring higher doses to achieve the same therapeutic effect.

To maximize the benefits of the medication while minimizing the risk of tolerance, the recommended practice is to apply the patch for a specific period and then remove it for a prolonged duration. This intermittent use allows for a "nitrate-free" period, helping to maintain the efficacy of the drug when it is reapplied.

In contrast, leaving the patch on for 24 hours continuously would not permit this important break and could potentially lead to tolerance. Changing the patch every 8 hours may not provide adequate time for a nitrate-free interval. Applying the patch to the same area each day does not align with the best practices for skin irritation and absorption variability; it is generally recommended to rotate application sites.