Question

A nurse is caring for a client who is on bed rest and has a new prescription for enoxaparin subcutaneous. Which of the following actions should the nurse take?

a. Monitor the client's INR daily
b. Expel air bubbles when using a prefilled syringe
c. Inject the medication into the anterolateral abdominal wall
d. Massage the injection site after administration.

Answer 1

When administering enoxaparin, a nurse should not expel the air bubble from the prefilled syringe, inject into the antelateral abdominal wall, and avoid massaging the site post-injection. Monitoring INR is not typically needed for enoxaparin.

Step-by-step explanation:

A nurse caring for a client who is on bed rest and has a new prescription for enoxaparin should perform specific actions to ensure the medication's effectiveness and the patient's safety. Enoxaparin is an anticoagulant medication used to prevent and treat blood clots. When administering this medication subcutaneously, the nurse should:

• Not expel the air bubble from the prefilled syringe, as it is designed to ensure the entire dose of medication is administered.
• Inject the medication into the antelateral abdominal wall, which is the correct site to reduce the risk of damaging muscles or nerves.
• Avoid massaging the injection site after administration to prevent forming a hematoma or altering the medication's absorption.

Monitoring the client's INR (International Normalized Ratio) is not typically necessary with enoxaparin, since it does not affect the INR to a significant extent; this monitoring is more relevant for those taking warfarin, another anticoagulant. Instead, the nurse can monitor the patient's platelet levels to watch for signs of heparin-induced thrombocytopenia. It's crucial that the nurse understands and follows these guidelines to provide the most effective and safe patient care.

Answer 2

c. Inject the medication into the anterolateral abdominal wall

The nurse should administer enoxaparin by injecting it into the anterolateral abdominal wall, without removing the air bubble from prefilled syringes or massaging the injection site afterwards.

Step-by-step explanation:

The correct action the nurse should take when administering enoxaparin subcutaneously to a client who is on bed rest is to inject the medication into the anterolateral abdominal wall. Enoxaparin is a low molecular weight heparin that does not typically require daily monitoring of the International Normalized Ratio (INR), making option A incorrect. While it is advised to remove air bubbles from a syringe to ensure proper dosing, prefilled syringes of enoxaparin are designed with an air lock to prevent the loss of medicine and should not be expelled, making option B incorrect. Lastly, it is recommended not to massage the injection site after administration of enoxaparin, as this can cause bruising or hematoma, making option D incorrect. The nurse should also ensure to rotate the injection sites to prevent bruising and administer enoxaparin at the same time each day to maintain therapeutic levels.