A nurse is preparing to administer enoxaparin to a client.
Which of the following actions should the nurse take?
Expel the air bubble from the syringe prior to injection.
Apply firm pressure to the injection site following administration.
Insert the syringe needle halfway into the client’s skin.
Administer the medication into the client’s muscles.
The Correct Answer is B
Choice A rationale:
The air bubble should not be expelled from the syringe before administering enoxaparin. The air bubble is included to ensure that the entire dose is administered and to help prevent leakage of the medication into the subcutaneous tissue, which can reduce bruising.
Choice B rationale:
After administering enoxaparin, applying firm pressure (but not massaging) to the injection site helps minimize bruising and bleeding. It's important not to massage the site as this can increase the risk of bleeding.
Choice C rationale:
The needle should be inserted fully into the subcutaneous tissue at a 90-degree angle (or at a 45-degree angle if the client has little subcutaneous tissue). Inserting the needle halfway may result in improper administration.
Choice D rationale:
Enoxaparin is a low-molecular-weight heparin that should be administered subcutaneously, not intramuscularly. Administering it intramuscularly could increase the risk of bleeding and is not the appropriate route for this medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Urticaria, also known as hives, is a common sign of an allergic reaction to penicillin. An allergic reaction is an abnormal response of the immune system to the drug. Other signs and symptoms of penicillin allergy may include skin rash, itching, fever, swelling, shortness of breath, wheezing, runny nose, itchy eyes, and anaphylaxis. Anaphylaxis is a rare but life-threatening condition that affects multiple body systems and requires immediate emergency treatment.
Choice A is wrong because pallor is not a typical sign of an allergic reaction to penicillin.
Pallor means pale skin and may be caused by other conditions such as anemia or shock.
Choice B is wrong because bradycardia is not a typical sign of an allergic reaction to penicillin.
Bradycardia means slow heart rate and may be caused by other conditions such as heart block or medication side effects.
Choice D is wrong because dyspepsia is not a typical sign of an allergic reaction to penicillin.
Dyspepsia means indigestion and may be caused by other conditions such as gastritis or peptic ulcer.
Correct Answer is A
Explanation
Laryngeal edema is a sign of a severe allergic reaction to amoxicillin that can cause difficulty breathing and may be life threatening.
The nurse should stop the medication and call for emergency assistance. Choice B is wrong because nausea is a common side effect of amoxicillin, not an allergic reaction.
Choice C is wrong because insomnia is not related to amoxicillin use. Choice D is wrong because cardiac dysrhythmia is not a typical symptom of an allergic reaction to amoxicillin.
It may be caused by other factors, such as underlying heart disease or electrolyte imbalance.
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