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Questions and Answers
What is the trade name for Heparin (low-molecular-weight) enoxaparin?
What is the trade name for Heparin (low-molecular-weight) enoxaparin?
- Coumadin
- Lovenox (correct)
- Warfarin
- Aspirin
Which classification does enoxaparin belong to?
Which classification does enoxaparin belong to?
- Anticoagulant (correct)
- Antihistamine
- Analgesic
- Antibiotic
What therapeutic action does enoxaparin have?
What therapeutic action does enoxaparin have?
Potentiate the inhibitory effect of antithrombin on factor Xa and thrombin.
Match the side effects with their categories:
Match the side effects with their categories:
What should nurses assess for in patients receiving enoxaparin?
What should nurses assess for in patients receiving enoxaparin?
Enoxaparin should be administered by slow iv injection of _____ mg protamine sulfate for each mg enoxaparin.
Enoxaparin should be administered by slow iv injection of _____ mg protamine sulfate for each mg enoxaparin.
Enoxaparin can be used interchangeably with unfractionated heparin.
Enoxaparin can be used interchangeably with unfractionated heparin.
What should patients do if they experience unusual bleeding or bruising while on enoxaparin?
What should patients do if they experience unusual bleeding or bruising while on enoxaparin?
Patients taking enoxaparin should avoid taking which of the following without consulting a healthcare provider?
Patients taking enoxaparin should avoid taking which of the following without consulting a healthcare provider?
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Study Notes
Lovenox Overview
- Generic name: enoxaparin; trade name is Lovenox.
- Classification: Therapeutic - anticoagulants; Pharmacologic - antithrombotics.
Therapeutic Action
- Enhances the inhibitory effect of antithrombin on factor Xa and thrombin.
- Primary use: prevention of thrombus formation.
Side Effects
- CNS: dizziness, headache, insomnia.
- CV: edema.
- GI: constipation, nausea, reversible increase in liver enzymes, vomiting.
- GU: urinary retention.
- DERM: ecchymoses, pruritus, rash, urticaria.
- HEMAT: bleeding, anemia, thrombocytopenia.
- Local: erythema, hematoma, irritation, pain at injection site.
- Misc: fever.
Nursing Implications and Assessment
- Check for signs of bleeding or hemorrhage, especially from surgical sites.
- Monitor for additional or increased thrombosis; symptoms vary based on the area involved.
- Evaluate for hypersensitivity reactions, such as chills and urticaria.
- Frequent neurological assessments for patients with epidural catheters.
- Observe injection sites for signs of hematoma or inflammation.
- Periodically monitor CBC, platelet count, and stools for occult blood during treatment.
- Watch for potential increases in AST and ALT levels.
- In case of overdose, administer protamine sulfate at a dosage of 1 mg for each mg of enoxaparin.
Potential Nursing Diagnoses
- Ineffective tissue perfusion.
- Risk for injury.
Implementation Guidelines
- High Alert: Verify patient's medication records to prevent accidental double dosing of heparin products.
- Cannot substitute low-molecular-weight heparin unit for unit with unfractionated heparin.
- Administer via deep SubQ injection; rotate sites on a daily basis.
- Use a 45 or 90-degree angle technique, without aspirating or massaging the injection site to avoid hematoma.
- Ice cube massage may help minimize bruising prior to injection.
- Do not expel the air bubble from the syringe before administering the injection to avoid loss of drug.
- Preferred injection areas are the anterolateral or posterolateral abdominal wall.
- After vascular procedures, hold doses for 6-8 hours and observe for bleeding at the access site.
Patient/Family Teaching
- Advise patients to report unusual symptoms such as bleeding, bruising, dizziness, or respiratory issues immediately.
- Instruct patients to avoid taking aspirin or NSAIDs without consulting healthcare providers.
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