A nurse is providing medication teaching for a patient who will begin taking diclofenac [Voltaren] gel for osteoarthritis in both knees and elbows. Which statement by the patient indi-cates understanding of the teaching?
a. "Because this is a topical drug, liver tox-icity will not occur."
b. "I should cover areas where the gel is ap-plied to protect them from sunlight."
c. "I will apply equal amounts of gel to all affected areas."
d. "The topical formulation has the same toxicity as the oral formulation."
B
Diclofenac is available in topical and oral preparations. Patients should be warned to protect treated areas from sunlight. Side effects occur, such as liver toxicity, even with topical dosing. Patients should apply smaller amounts to the upper extremities. Systemic toxicity is lower with topical formulations.
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