A nurse is conducting a health education about viral hepatitis B (HBV)in a community setting. An individual plans to travel to a country where hepatitis B is common. What will the nurse teach is the only preventive measure for HBV?

A. "It eliminates the clotting factors." - This statement suggests a misunderstanding of how enoxaparin works. Enoxaparin is a low molecular weight heparin that does not eliminate clotting factors but rather inhibits the activity of factor Xa, a key enzyme involved in the coagulation cascade. By inhibiting factor Xa, enoxaparin prevents the conversion of prothrombin to thrombin, thereby reducing the formation of fibrin clots. It does not eliminate existing clotting factors from the bloodstream.

B. "This medication will keep the blood clot from growing larger." - This statement demonstrates a correct understanding of enoxaparin's mechanism of action. Enoxaparin is an anticoagulant medication that works by preventing the enlargement of existing blood clots. By inhibiting the activity of factor Xa, enoxaparin prevents the conversion of prothrombin to thrombin, thereby reducing the formation of fibrin clots and preventing existing clots from growing larger.

C. "This medication will decrease my risk for bleeding." - This statement is incorrect. Enoxaparin, like other anticoagulants, actually increases the risk of bleeding due to its mechanism of action. By inhibiting the coagulation cascade, enoxaparin prolongs the time it takes for blood to clot, which can lead to an increased risk of bleeding, particularly in patients who are predisposed to bleeding or are taking other medications that affect clotting.

D. "I will get this medication in my veins." - This statement is incorrect. Enoxaparin is administered subcutaneously, not intravenously. It is usually injected into the fatty tissue of the abdomen or thigh using a prefilled syringe with a short, thin needle. The subcutaneous route of administration allows for slow absorption and sustained anticoagulant effects over time.

A. Administer post-exposure prophylaxis medication: While post-exposure prophylaxis (PEP) medication may be necessary in certain cases of needlestick injuries involving potential exposure to HIV, it is not the first step to perform. The initial priority is to ensure the safety of the healthcare provider and prevent potential transmission of the virus.

B. Determine the HIV status of the patient: Determining the HIV status of the patient is essential for risk assessment and guiding subsequent management. However, this step may take some time, and immediate action to protect the healthcare provider should not be delayed while waiting for the patient's HIV status to be confirmed.

C. Advise exposed healthcare providers to use precautions: This is the first step to perform after a needlestick injury. Healthcare providers should be immediately advised to use standard precautions, including hand hygiene and the use of personal protective equipment, to minimize the risk of transmission of bloodborne pathogens.

D. Undergo early reevaluation after exposure: Early reevaluation after exposure is important to assess the risk of transmission and determine the need for further interventions, including PEP medication. However, advising exposed healthcare providers to use precautions should take precedence as an immediate response to the injury.