A nurse is preparing to administer potassium chloride 30 mEq PO daily. The amount available is potassium chloride 20 mEq/15mL. How many mL should the nurse administer?

(Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A. Clotting at the incision site. Enoxaparin (Lovenox) is an anticoagulant medication used to prevent blood clots, particularly deep vein thrombosis (DVT) and pulmonary embolism (PE), which are common complications following orthopedic surgeries like knee replacement. Monitoring for clotting at the incision site is essential to ensure that the medication is effectively preventing excessive clot formation while also ensuring that the patient does not experience excessive bleeding.

B. Increased pain. While increased pain could be a concern postoperatively, particularly after a surgical procedure like knee replacement, it is not a specific monitoring parameter for enoxaparin administration. Pain management is typically addressed separately, and increased pain may indicate issues such as inadequate analgesia, surgical complications, or other factors unrelated to enoxaparin therapy.

C. Gingival hyperplasia. Gingival hyperplasia refers to an overgrowth of gum tissue and is not directly associated with enoxaparin therapy. This side effect is more commonly associated with certain medications such as phenytoin and cyclosporine rather than anticoagulants like enoxaparin. Monitoring for gingival hyperplasia would not be relevant in this context.

D. Signs and symptoms of bruising and bleeding. This is the correct answer. Enoxaparin is an anticoagulant medication, which increases the risk of bleeding. Therefore, monitoring for signs and symptoms of bruising and bleeding is crucial to detect any potential complications such as hemorrhage or hematoma formation. This includes assessing for unusual bruising, bleeding from the gums, nosebleeds, hematuria, melena, or any other signs of internal or external bleeding. Prompt recognition and management of bleeding complications are essential to ensure patient safety during enoxaparin therapy, especially following orthopedic surgery.

White Blood Cells (WBCs): WBCs are part of the immune system and play a role in fighting infections. However, they are not directly involved in hemostasis or clot formation.

Antibodies: Antibodies are proteins produced by the immune system to recognize and neutralize foreign substances (antigens). They do not directly participate in clot formation.

Red Blood Cells (RBCs): RBCs carry oxygen and carbon dioxide but are not directly involved in clotting. They do not adhere to the vessel wall during hemostasis.

Platelets: Platelets are small cell fragments in the blood. They clump together (aggregate) at the site of injury to form a temporary plug (platelet plug). Platelets adhere to the injured vessel wall and release chemicals that initiate clotting.