Definition
Applying topical medications involves delivering drugs directly to the skin or mucous membranes to treat localized conditions like rashes, infections, or inflammation.
Purposes
- To protect, soothen or soften surface areas.
- To warm an affected area and also for muscle relaxation.
- To relieve itching.
- To check the growth of microorganisms.
Types of Topical medications and Their Uses
| Formulation | Texture & Absorption | Best For |
|---|---|---|
| Cream | Light, water-based | Moist or weeping lesions (e.g., eczema) |
| Ointment | Greasy, oil-based | Dry, scaly skin; enhances absorption |
| Gel | Clear, fast-drying | Hairy areas, acne, burns |
| Lotion | Thin, fluid-like | Large or hairy areas; mild inflammation |
| Powder | Dry, absorbent | Fungal infections, moist folds |
| Transdermal Patch | Controlled systemic delivery | Pain, hormone therapy, nicotine replacement |
Articles
A tray containing:
- Gloves.
- Coton balls or gauze pieces.
- Medicine (ointment, lotion or liniment) in appropriate container.
- Adhesive tape and dressing pad.
- Kidney tray.
Procedure
Applying Lotions or Liniments
| Nursing Action | Rationale | |
| 1. | Before procedure Identify the patient and explain the procedure. | |
| 2. | During procedure Wash hands and don gloves on dominant hand. | Prevents spread of microorganisms. |
| 3. | Expose only the area where lotion/liniment to be applied. | Keeps patient warm and prevents undue exposure. |
| 4. | Clean the area with soap and water and pat dry if required. | Skin encrustation can harbor microorganisms and previously applied medication remaining on the skin may reduce contact of medication with skin. |
| 5. | Apply skin preparation: Powders: Make sure that the skin surface is dry and sprinkle evenly over the area till a fine thin layer covers the skin. Cover the area with dressing if required. | Moisture can cause the powder to stick and cause uneven distribution. |
| Lotions: Shake the container and put a small amount of lotion on a gauze dressing pad and apply it evenly in the direction of hair growth. | Shaking the container ensures proper mixing of medication. | |
| Creams, ointments, and pastes-Take a small quantity of medication in gloved hand. Smear it evenly over skin using long strokes in the direction of hair growth. Apply dressing if required. | Smearing medication evenly on the skin ensures uniform distribution. | |
| Aerosol spray: Shake the container well to mix contents. Hold the container at 15-30 cm away from the area and spray. Ensure that spray does not enter into or nose. | Aerosol spray if enters into eyes or nose can cause adverse effects. | |
| Transdermal patches: Select clean dry area which is free of hair. Take the patch holding it without touching the adhesive edges and apply it firmly using palm of hand and press it for 10 seconds. Remove the patch at the appropriate time folding it with the medicated side inside. | Hair growth in the area of application can affect the absorption of medication. Applying the patch for longer time than required can cause increased rate of absorption than required. | |
| 6. | After procedure Observe the area carefully for changes in color, swelling, and appearance of a rash or other observable signs. |
Special Considerations
- Avoid applying to broken or irritated skin unless prescribed.
- Do not rub vigorously can cause irritation or increase absorption.
- Rotate transdermal patch sites to prevent skin breakdown.
- Monitor for local or systemic reactions (e.g., rash, burning, dizziness).
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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